Anatomy MCQ PDF

CHAPTER 1
ANATOMY
KEY POINTS
DIAPHRAGMATIC OPENINGS
Level of vena caval opening: T8

Level of esophageal opening: T10
Level of aortic opening: T12
Caval opening is through: Central part
Aortic opening is through: Osseo-aponeurotic opening (not a true opening)
Esophageal opening is through: Muscular part of diaphragm
Right phrenic nerve passes through: Vena caval opening
Vagus nerve passes through: Esophageal opening
Esophageal branch of left gastric artery passes through: Esophageal opening
Azygous vein passes through: Aortic opening
ARTERIES
Formed by union of 2 vertebral arteries: Basilar A.

Inferior vesical artery is a branch of: Anterior division of internal iliac artery
Uterine A. is a branch of: Anterior division of internal iliac A.
Inferior thyroid A. is a branch of: Thyrocervical trunk
Ascending pharyngeal A. is a branch of: External carotid A.
Internal pudendal A. is a branch of: Anterior division of Internal iliac A.
Left gastro-epiploic A. is a branch of: Splenic A.
Splenic A. is a branch of: Coeliac trunk
Cystic A. is a branch of: Right hepatic A.
Cilio-retinal A. is a branch of: Choroidal A.
Middle meningeal A. is a branch of: Maxillary A.
Anterior spinal A. is a branch of: Vertebral A.
Ophthalmic A. is a branch of: Internal carotid A.
Medially, superior thyroid artery is related to: External branch of superior laryngeal nerve
EMBRYOLOGY
rochordal plate & primitive streak is seen on: 14th day

P
Oogonia & germ cell are derived from: Yolk sac
Self-Assessment & Review of FMGE/MCI Screening Examination
1st polar body is formed during: Oogenesis

1st polar body is extruded: At the time of ovulation
Y chromosome is: Acrocentric
Sperms are stored in: Epididymis
Length of human sperm: 50-60 microns
Number of chromosomes are reduced down to half in: 1st meiotic division
In humans, implantation begins on the: 6th day after fertilization
Initiation and maintainance of primitive streak is because of: Nodal gene
Primitive streak develops in which week: 3rd week
Structure developed from cloaca:
The cloaca develops into the rectum and upper 2/3 of the anal canal,
While its anterior subdivision, the urogenital sinus, develops into the bladder and
In the female, the urethra and vestibule,
While in the male the prostatic urethra.
Anomaly of pancreas in which the parts of the pancreas derived from the dorsal & ventral buds fail to fuse with each other:
Divided pancreas
FETAL STRUCTURES & ADULT REMNANTS
Meckels divertculum: Remnant of vitelline duct

Ligamentum venosum: Remnant of ductus venosus
Ligamentum arteriosum: Remnant of ductus arteriosus
Median umbilical ligament: Remnant of urachus
Medial umbilical ligaments: Remnant of 2 umbilical arteries
DERIVATIVES OF GERM LAYERS
esodermal in origin: Kidney, Muscle (EXCEPT musculature of iris), Bone etc.

M
Trigone of bladder: Mesoderm
Somites: Paraxial mesoderm
Epithelial lining of biliary tract: Endoderm
Tympanic membrane: All the 3 germ layers
Derivatives of neural crest:
yy Neurons of
Dorsal root,
Sensory &
Autonomic/ sympathetic ganglia
yy Schwann cells,
yy Melanocytes,
yy Mesenchyme of dental papillae etc.
EMBRYOLOGY OF GENITOURINARY SYSTEM
Collecting duct develops from: Ureteric bud

Epithelium of ureter develops from: Mesonephros
Uterus/ appendix testes develops from: Mullerian duct/ paramesonephric duct
Ovary develops from: Genital ridge
Scrotum develops from: Genital swelling
Clitoris develops from: Genital tubercle
2
Anatomy
PHARYNGEAL ARCH DERIVATIVES
Meckels cartilage develops from: 1st pharyngeal arch

Sphenomandibular ligament develops from: 1st pharyngeal arch
Stapes develops from: 2nd pharyngeal arch
Stylohyoid ligament develops from: 2nd pharyngeal arch
Greater cornua of hyoid develops from: 3rd pharyngeal arch
Posterior belly of digastric develops from: 2nd pharyngeal arch
Anterior belly of digastric develops from: 1st pharyngeal arch
Platysma develops from: 2nd pharyngeal arch
DERIVATIVES OF PHARYNGEAL POUCHES
Palatine tonsil develops from: 2nd pharyngeal pouch

Inferior parathyroid gland & thymus develops from: 3rd pharyngeal pouch
Superior parathyroid gland & ultimobranchial body develops from: 4th pharyngeal pouch
Parafollicular cells are derived from: Ultimobranchial body
TONGUE
Muscle of tongue develops from: Occipital myotomes

Muscles of tongue are: Both smooth & skeletal muscles
Safety muscle of tongue: Genioglossus
Pain of Ca base of tongue is referred to the ear through: Glossopharyngeal nerve
Circumvallate papillae of tongue are supplied by: Glossopharyngeal nerve
Anterior 2/3rd of tongue develops from:
yy Lingual swellings &
yy Tuberculum impar
Tate sensation from anterior 2/3rd of tongue is by: Chorda tympani (facial)
Posterior 1/3rd of tongue develops from: Hypobranchial eminence
EPITHELIUM
esothelium of pleura, peritoneum & pericardium is lined by: Simple squamous epithelium
M
Nasal cavity, nasal air sinuses, nasopharynx, larynx (EXCEPT vocal cords), trachea & bronchi are lined by: Ciliated pseu-
do-stratified columnar epithelium
True vocal cords, cornea, tonsil & vagina are lined by: Non keratinized stratified squamous epithelium
Epithelium with extra reserve of cell membrane: Transitional epithelium
Calyces, ureter, ureterovesical junction & urinary bladder have: Transitional epithelium
HISTOLOGICAL FEATURES
Brunners gland is present in: Duodenum

Function of gap junctions: Exchange between cells
Gustatory system has: Sensory type of neuro-epithelium
Intercalated disc is present in: Cardiac muscle
Nucleus in cardiac muscle: Central
Reticuloendothelial cells of liver are: Kupffer cells
Space of Disse & space of Mall are seen in: Liver
Intrinsic factor (Castle) is secreted by: Parietal/ oxyntic cells
Chief/ peptic/ zymogen cells lines the: Body of the gland (secrete pepsinogen)
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Paneth cells (intestine) are rich in: Rough ER

Epiglottis is an example of: Elastic cartilage
BRACHIAL PLEXUS
Nerve arising from the trunks of brachial plexus:

yy Suprascapular nerve,
yy Subclavius nerve
Musculocutaneous nerve arises from: Lateral cord
Subscapular nerve arises from: Posterior cord
Erbs point is: Union of C5 & C6
Erbs palsy involves: Upper trunk of brachial plexus
Klumpkes paralysis is: Injury to lower trunk of brachial plexus
HAND
Hypothenar area (medial third of palm) is supplied by: Ulnar nerve

Palmar & dorsal interossei are supplied by: Ulnar nerve
Adductor pollicis (adduction of thumb) is supplied by: Ulnar nerve
Froment sign/ Book test is done for: Ulnar nerve injury
Thenar eminence is supplied by: Median nerve
Lunate dislocation may injure: Median nerve
Ape thumb deformity is seen in: Median nerve injury
HIP & THIGH
Nerve of medial/ adductor compartment of thigh: Obturator nerve

Gluteus maximus is supplied by: Inferior gluteal nerve
Gluteus minimus, G. medius & tensor fascia lata is supplied by: Superior gluteal nerve
Action of sartorius & piriformis: Lateral rotation
Superior & inferior gemelli action: Lateral rotation
Abductors of the hip: Gluteus medius & gluteus minimus
Function of ileofemoral ligament/ ligament of Bigelow: Prevents hyperextension at the hip
Root value of pudendal nerve: S2, S3, S4
Root value of obturator nerve: L2, L3, L4
KNEE
Extensor of the knee joint: Quadricep femoris

Posterior dislocation of femur is prevented by: Anterior cruciate ligament
Posterior dislocation of the tibia is prevented by: Posterior cruciate ligament
ESOPHAGUS
Esophagus pierces diaphragm at a distance of: 15 inches (from incisor)

Length of esophagus: 25 cm
Esophagus commences at: Lower end of cricoid
Epithelium of esophagus: Stratified squamous non keratinized
Most common site for oesophageal obstruction: Crico-oesophageal junction
4
Anatomy
HEART
I nferior surface of the heart is formed by: Both ventricles

Base of heart is formed by: Both atrium
Part of heart lying close to esophagus: Left atrium
Trabeculae carnea is present in: Right ventricle
Anterior wall of left ventricle is supplied by: Left anterior descending artery
Right coronary artery arises from: Anterior aortic cusp
In right dominance, posterior interventricular artery originates from: Right coronary artery
SA node, AV node & AV bundle is supplied by: Right coronary artery
Middle cardiac vein follows: Posterior interventricular artery
SVC & IVC opens into: Right atrium
Coronary sinus drains into: Right atrium
CRANIAL NERVES
Artery crossing optic nerve: Ophthalmic artery

Cranial nerve having longest intracranial course: Trochlear
Cranial nerve 3 & 4 have their nuclei in: Midbrain
Cranial nerve 9, 10, 11, 12 have their nuclei in: Medulla
Cranial nerve emerging from the dorsal aspect of brain: Trochlear
Muscles supplied by facial nerve:
yy Platysma,
yy Muscles of facial expression,
yy Buccinator etc.
Glands supplied by facial nerve:
yy Submandibular,
yy Lacrimal,
yy Nasal glands
Gustatory sensation to soft palate is carried by: Facial nerve
Ganglion related to facial nerve:
yy Pterygopalatine ganglion,
yy Geniculate ganglion etc.
Arterial supply to facial nerve: Ascending pharyngeal artery
All palatal muscles (except tensor palati) are supplied by: Cranial part of Accessory nerve
Right hypoglossal nerve palsy will deviate the tongue to: Right side
Paralysis of 3, 4 & 6 cranial nerve indicates lesion of: Cavernous sinus (these nerve lies in lateral wall of cavernous sinus)
Afferent pathway of corneal reflex: Trigeminal nerve (nasociliary branch of ophthalmic/ V1 division)
FORAMEN OF SKULL
Contents of optic canal:

yy Optic nerve &
yy Ophthalmic artery
Contents of foramen rotundum: Maxillary division of cranial nerve V
Contents of foramen ovale:
yy Mandibular division of cranial nerve V,
yy Accessory meningeal artery etc.
Contents of foramen spinosum:
yy Middle meningeal artery,
yy Meningeal branch of the mandibular nerve etc.
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Contents of foramen magnum:

yy Accessory nerve,
yy Vertebral & spinal arteries (NOT spinal cord) etc.
Contents of jugular foramen:
yy 9, 10 & 11 cranial nerves,
yy Internal jugular vein,
yy Inferior petrosal sinus
Contents of internal auditory meatus:
yy 7 & 8 cranial nerve,
yy Labyrinthine artery
Content of Dorellos canal: Cranial nerve 6
LARYNX
Cartilages of larynx: 3 paired & 3 unpaired

Sensory innervation above the level of vocal cords is by: Internal laryngeal nerve
Sensory innervation of larynx below the level of vocal cords: Recurrent laryngeal nerve
Nerve supply of cricothyroid: External laryngeal nerve
Abductor of vocal cords: Posterior crico-arytenoid
Tensor of vocal cords: Cricothyroid
BRAIN
rimary auditory area is in: Superior part of the temporal gyrus

P
Primary visual area is in: Occipital lobe
Loss of tactile localization & 2 point discrimination occurs in damage to: Somatosensory area 1
Functions of limbic system:
yy Emotions,
yy Memory &
yy Higher functions
LYMPAHTIC DRAINAGE
Lymphatics drainage of testis: Para-aortic node

Clitoris & glans penis: Cloquet node/ Rossenmullers node
Labium majus: Superficial inguinal node
Testis: Pre-aortic & para-aortic nodes
Tip of tongue: Submental nodes
Spongiform urethra: Deep inguinal nodes
Lymphatics are not present in: Brain, choroid, internal ear, cornea
VEINS
Left gonadal vein drain into: Left renal vein

Great cerebral vein (of Galen) is formed by the union of: Internal cerebral veins
Great cerebral vein drains into: Straight sinus
Portal vein is formed by: Union of splenic vein & superior mesenteric vein (behind neck of pancreas)
Normal portal pressure is: 5-10 mm Hg
EXCEPTS IN ANATOMY
ll intrinsic muscle of larynx are supplied by recurrent laryngeal nerve except: Cricothyroid (external laryngeal nerve)
A
All muscles of tongue are supplied by hypoglossal nerve except: Palatoglossus (pharyngeal plexus)
6
Anatomy
ll muscles of pharynx are supplied by pharyngeal plexus except: Stylopharyngeus (Glossopharyngeal nerve)
A
All muscles of the soft palate are supplied by pharyngeal plexus except: Tensor palati (nerve to medial pterygoid)
Quick Review (Including FMGE Questions)

1. Superior & inferior radioulnar joints are an example of: Pivot joint
2. Nerve supply of platysma: Facial nerve
3. Salivary gland, NOT supplied by facial nerve: Parotid
4. All palatal muscles are supplied by cranial accessory nerve through pharyngeal plexus EXCEPT: Tensor veli palatini
5. Azygos vein passes through Aortic hiatus
6. Source of bleeding in extradural hemorrhage: Middle Meningeal artery
7. Haversian canal is a histological feature of: Compact bone/ cortex
8. Uterine artery is a branch of: Anterior division of Iliac artery
9. 1st polar body is extruded at the time of: Ovulation
10. Meckels diverticulum is a remnant of: Vitellointestinal duct
11. Structure derived from all the three germ layers: Tympanic membrane/ ear drum
12. Stapes develop from IInd pharyngeal arch
13. Safety muscle of tongue: Genioglossus
14. Taste sensation from anterior 2/3rd of tongue is carried by: Chorda tympani
15. Epithelial lining of tonsil: Stratified squamous non-keratinized epithelium
16. Peritoneal cavity is lined by: Simple squamous epithelium
17. Intercalated disc is a histological feature of: Cardiac muscle
18. Erbs point is: C5, C6
19. Injury to lower trunk of brachial plexus is known as: Klumpkes palsy
20. Adductor pollicis is supplied by: Ulnar nerve
21. Teres minor & deltoid muscle are supplied by: Axillary nerve
22. Nerve supply of gluteus maximus: Inferior gluteal nerve
23. Ligament preventing hyperextension at the hip joint: Iliofemoral ligament/ Ligamnet of Bigelow
24. Inversion & eversion occurs at Subtalar joint
25. Joint between epiphysis & diaphysis is: Primary cartilaginous
26. Vessels in umbilical cord: 2 arteries & 1 vein (right vein disappears, left vein is LEFT)
27. Ligamentum arteriosum is derived from: Ductus arteriosus
28. Artery present in anatomical snuff box: Radial artery
29. Sperm are stored in: Epididymis
30. Hassals corpuscles is seen in: Thymus
31. Peyers patches are present in: Ileum
32. Nerve supply to hypothenar muscle is from: Ulnar nerve
33. Nerve passing deep to flexor retinaculum at wrist: Median nerve
34. Nerve related to spiral groove of humerus: Radial nerve
35. Azygos veins drain into: Superior Vena Cava
36. Housemaids knee is inflammation of Prepatellar bursa
37. Superficial inguinal ring is a defect in the: External oblique aponeurosis
38. Left testicular vein drains into: Left renal vein
39. Left gastro-epiploic artery is a branch of: Splenic artery
40. MC position of appendix: Retrocaecal
41. Nasolacrimal duct opens into inferior meatus
42. Parasympathetic secretomotor fibres to submandibular gland is through: Facial nerve
43. Opening of parotid duct: Opposite upper 2nd molar
44. Abductor of vocal cord: Posterior cricoarytenoid
45. In adults spinal cord ends at the lower border of L1 vertebra (in children, it is at lower border of L3)
46. Muscle supplied by spinal part of accessory nerve: Sternocleidomastid & trapezius
47. Unlocking of knee is done by: Popliteus
48. Type of cartilage in auricle of ear: Elastic
49. Nerve supply of superior oblique muscle: Trochlear
50. Muscle producing abduction, intorsion & depression of eyeball: Superior Oblique
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ANATOMY (QUESTIONS)
EMBRYOLOGY c. Left fourth aortic arch artery

d. Right third aortic arch artery
1. Pulmonary veins develops from: September 2004 11. Lens is derived from: March 2007, September 2010
a. 6th aortic arch September 2012, March 2013 (f, g)
b. Primitive left atrium a. Endoderm
c. Left common cardinal vein b. Surface ectoderm
d. Left vitelline vein c. Mesoderm
2. First polar body is extruded at: March 2012 d. None of the above
a. At the time of menstruation 12. Fate of notochord is: September 2008
b. At the time of ovulation a. Annulus fibrosis
c. At the time of fertilization b. Nucleus pulposus
d. At the time of menopause c. Vertebral foramen
3. Primordial germ cells are derived from: March 2012 d. Spinous process
a. Neural crest 13. Trigone of urinary bladder develops from: March 2009
b. Genital ridge a. Mesoderm
c. Somatopleuritic mesoderm b. Ectoderm
d. Yolk sac c. Endoderm of urachus
4. Cervix develops from: March 2013 (b, g) d. None of the above
a. Urogenital sinus 14. In the adult heart, floor of fossa ovalis represents:
b. Mesonephric duct a. Septum intermedium March 2009
c. Paramesonephric duct b. Septum primum
d. Mesonephric tubules c. Septum spurium
5. Lower part of vagina develops from: March 2013 (c, f) d. Septum secundum
a. Urogenital sinus 15. Which part of the ear has origin from all the three
b. Mesonephric duct layers of germ layer: March 2010
c. Paramesonephric duct a. Auricle
d. Mesonephric tubules b. Tympanic membrane
6. Implantation occurs in which stage: March 2013 (d) c. Ossicles
a. Morula d. Middle ear cavity
b. Zygote 16. True diverticulum is: March 2010
c. Blastocyst a. Zenkers diverticulum
d. Blastomeres b. Meckels diverticulum
c. Duodenal diverticulum
7. Which is NOT derived from second pharyngeal arch:
d. Bladder diverticulum
a. Posterior belly of digastric March 2013 (e)
b. Anterior belly of digastric 17. Which of the following artery is present in anatomical
c. Buccinator snuff box: September 2010
d. Platysma a. Anterior interosseous artery
b. Brachial artery
8. Umbilical cord contains: September 2005
c. Radial artery
March 2013 (a,b, e) d. Ulnar artery
a. 2 arteries and 2 veins 18. Which of the following is not a constituent of
b. 1 artery and 2 veins umbilical cord: March 2011
c. 1 artery and 1 vein a. Whartons jelly
d. 2 arteries and 1 vein b. 2 arteries and 1 vein
9. Ligamentum arteriosum is derived from: March 2005 c. Cloacal duct
a. Ductus arteriosus d. Allantois
b. Ductus venosus 19. Function of umbilical vein is:
c. Ductus utriculosaccularis March 2011 and 2013 (a, e)
d. Ductus reunions a. Carry oxygenated blood away from the fetus
10. Arch of aorta develops from: September 2006 b. Carry oxygenated blood towards the fetus
a. Right fourth aortic arch artery c. Carry deoxygenated blood away from the fetus
b. Left third aortic arch artery d. Carry deoxygenated blood towards the fetus
8
Anatomy
20. Ligamentum teres is: March 2011 d. Stratified squamous keratinized

a. Remnant of ductus arteriosus 30. Glands are ABSENT in mucosa of: March 2013 (b)
b. Remnant of umbilical vein a. Cervix
c. Remnant if ductus venosus b. Uterus
d. Remnant of umbilical artery c. Vagina
21. Anatomical obliteration of ductus arteriosus occurs d. All of the above
at: September 2011 31. Ectocervix is lined by: March 2013 (b)
a. Birth a. Non-ciliated columnar epithelium
b. 3-4 day b. Stratified squamous epithelium
c. 10 day c. Ciliated columnar epithelium
d. 30 day d. Cuboidal epithelium
22. Which is not associated with vitello-intestinal duct: 32. Pneumocytes are cells found in epithelial lining of:
a. Ileal diverticulum March 2011 a. Alveoli March 2013 (b)
b. Umbilical fistula b. Bronchus
c. Enterocystoma c. Trachea
d. Mesenteric cyst d. Bronchioles
23. Implantation (of blastocyst) occurs on which day after 33. Tendon are made up of: March 2013 (e)
fertilization: September 2011 a. Collagen fibres
a. 12 b. Elastin
b. 10 c. Keratin
c. 8 d. Myofibrils
d. 6
34. Pseudostratified columnar epithelium is present in:
24. Sperm attains motility in: September 2011 a. Esophagus March 2013 (f)
a. Vas deferens b. Vas deferens
b. Rete testis c. Cornea
c. Seminal vesicle d. Thyroid
d. Epididymis
35. Mucous membrane of vagina is lined by:
25. Clitoris develops from which of the following:
September 2005
a. Genital tubercle September 2011
a. Nonkeratinized Stratified Squamous epithelium
b. Genital ridge
b. Keratinized Stratified Squamous epithelium
c. Wolffian duct
c. Columnar cells
d. Mullerian duct
d. Cuboidal epithelium
HISTOLOGY 36. Gland of Brunners is found in: September 2005
a. Jejunum
26. Transitional epithelium is seen in: March 2012 b. Duodenum
a. Gall bladder c. Ileum
b. Urinary bladder d. All
c. Thyroid 37. Not a layer of retina: September 2007
d. Tongue a. Outer limiting membrane
27. Stratified squamous epithelium is seen at all the b. Retinal pigment epithelium
following sites EXCEPT: March 2012 c. Bowmans membrane
a. Skin d. Ganglion cell layer
b. Vagina
38. True about cardiac muscles are all except:
c. Esophagus
d. Gall bladder September 2007, September 2010
a. Property of spontaneous and rhythmic contraction
28. Which of the following does NOT have non-kerati-
b. Cardiac muscle exhibits cross striations
nized stratified squamous epithelium: September 2012
c. Cardiac muscle cells are linear and longitudinal
a. Cornea
b. Vagina d. Cardiac muscle is supplied by autonomic nerve
c. Esophagus fibers
d. Uterus 39. Simple cuboidal epithelium is seen in: September 2008
29. Epithelial lining of esophagus is: March 2013 (a) a. Skin
a. Cuboidal b. Trachea
b. Columnar c. Oesophagus
c. Stratified squamous non-keratinized d. Thyroid gland
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40. Hassals corpuscles are seen in: September 2009 50. Upper boundary of quadrangular space is formed by:
a. Thymus a. Teres major September 2004
b. Spleen b. Teres minor
c. Bone marrow c. Long head of triceps
d. Lymph node d. Surgical neck of humerus
41. Blood testis barrier is formed by the: September 2009 51. Structure passes through upper triangular space:
a. Leydig cells a. Profunda brachii September 2004
b. Anterior circumflex humeral artery
b. Sertoli cells
c. Posterior circumflex humeral artery
c. Germ cells
d. Circumflex scapular artery
d. All of the above
52. True regarding beginning of superficial palmar arch:
42. Fenestrated capillaries are found in all except : March 2012
a. Renal glomeruli September 2009 a. At the level of proximal transverse crease of wrist
b. Intestinal villi b. Below distal transverse crease of wrist
c. Pancreas c. At the level of proximal palmar crease
d. Muscle d. At the distal border of thumb on palmar surface
43. Goblet cells are not seen in: September 2009 53. Froment test is positive in lesion of: September 2012
a. Colon a. Radial nerve
b. Trachea b. Ulnar nerve
c. Conjunctiva c. Axillary nerve
d. Esophagus d. Median nerve
44. Peyers patches are present in: September 2010 54. Winging of scapula is due to: September 2012
a. Duodenum a. Medial pectoral nerve palsy
b. Lateral pectoral nerve palsy
b. Jejunum
c. Nerve to serratus anterior palsy
c. Ileum
d. Nerve to Latissimus dorsi palsy
d. Stomach
55. All form the posterior wall of axilla EXCEPT:
45. Periarteriolar lymphoid sheaths are seen in which
a. Subscapularis March 2013 (a)
organ: September 2011
a. Liver b. Subclavius
b. Spleen c. Teres major
c. Kidney d. Latissimus dorsi
d. Heart 56. Muscle forming the medial wall of axilla is:
46. Uterus, before menarche, is lined by: September 2011 a. Subscapularis March 2013 (f)
a. Ciliated columnar epithelium b. Teres major
b. Stratifies squamous non-keratinized epithelium c. Teres minor
c. Startifies squamous keratinized epithelium d. Serratus anterior
d. Cuboidal epithelium 57. Deformity associated with ulnar nerve injury is:
a. Wrist drop March 2013 (b)
SUPERIOR EXTREMITY b. Simon hand
c. Claw hand
47. Which of the following is NOT a content of the d. Ape thumb deformity
axilla: March 2003
a. Axillary vessels 58. Musculocutaneous nerve supplies all of the following
b. Axillary tail of the breast EXCEPT: March 2013 (c)
c. Roots of brachial plexus a. Coracobrachialis
d. Intercostobrachial nerve b. Biceps brachii
c. Brachialis d. Brachioradialis
48. Which of the following walls of axilla is formed by
shaft of humerus: September 2003 59. All of the following are branches from the CORDS of
a. Anterior brachial plexus EXCEPT: March 2013 (d, h)
b. Posterior a. Suprascapular nerve
c. Medial b. Upper subscapular nerve
d. Lateral c. Lower subscapular nerve
49. FALSE about supraspinatus: September 2003 d. Lateral pectoral nerve
a. Rotator cuff muscle which does not rotate humerus 60. Root value of the Radial nerve is: September 2005
b. Lies deep to coracoacromial arch a. C5, C6
c. Abduct the arm to horizontal level b. C5, C6, C7
d. Most commonly involved in rotator cuff injury c. C5, C6, C7, C8 d. C5, C6, C7, C8, T1
10
Anatomy
61. Which of the following is an artery of the forearm: b. Ulnar nerve

a. Brachial artery September 2006 c. Radial nerve
b. Axillary artery d. Median nerve
c. Ulnar artery 72. Bone, which usually does not have a medullary
d. Femoral artery cavity: March 2011
62. Insertion of pectoralis major is at: September 2006 a. Fibula
a. Lateral lip of bicipital groove of humerus b. Clavicle
b. Medial lip of bicipital groove of humerus c. Humerus
c. In the bicipital groove of humerus d. Ulna
d. Clavicle 73. Lower angle of scapula corresponds to which vertebral
63. Labourers nerve is another name for which nerve: level: September 2011, March 2013 (a)
a. Median nerve March 2007 a. D5
b. Radial nerve b. D7
c. Ulnar nerve c. D9
d. Axillary nerve d. D12
64. Nerve roots involved in Erbs palsy: September 2009
a. C5, C6 THORAX
b. C6, C7
c. C7,C8,T1 74. Lower limit of left crus of diaphragm is at which
d. C5,C6,C7,C8,T1 vertebral level: September 2004
a. 8th dorsal
65. Partial Claw hand is due to: September 2007
b. 10th dorsal
a. Radial nerve injury March 2013 (b, f, g)
c. 2nd lumbar
b. Ulnar nerve injury
d. 3rd lumbar
c. Median nerve injury
d. Axillary nerve injury 75. Vein opening directly into right atrium: September 2004
a. Anterior cardiac vein
66. Structures piercing clavipectoral fascia are all except:
b. Middle cardiac vein
a. Cephalic vein September 2007
c. Great cardiac vein
b. Thoracoacromial artery
d. Small cardiac vein
c. Lateral pectoral nerve
d. Basilic vein 76. Channel which drains major part of myocardium:
a. Coronary sinus September 2004
67. All of the following muscles of the pectoral girdle
b. Great cardiac vein
are innervated by branches from the brachial plexus:
c. Anterior cardiac vein
except: March 2008
d. Venae cordis minimae
a. Subclavius
b. Serratus anterior 77. Sternal angle corresponds to: September 2012
c. Rhomboid major a. 1st rib
d. Trapezius b. 2nd rib
c. 3rd rib
68. Nerve supply to hypothenar muscles is from :
d. 4th rib
a. Ulnar nerve March 2009
b. Median nerve 78. Muscle used for inspiration during quite breathing:
c. Radial nerve a. Diaphragm September 2012
d. Musculocutaneous nerve b. Rectus abdominis
c. Sternocleidomastoids
69. Structure passing deep to flexor retinaculum at wrist:
d. Scaleni
a. Ulnar nerve September 2009
b. Median nerve 79. In a standing man, in midaxillary line, lower border of
c. Radial nerve pleura reaches: March 2013 (b, f, h)
d. Ulnar artery a. 6th rib
b. 8th rib
70. The ligament which transfers weight of arm to the
c. 10th rib
trunk: March 2009
d. 12th rib
a. Costoclavicular ligament
b. Coracoclavicular ligament 80. NOT a content of middle mediastinum:
c. Coracoacromial ligament a. Ascending aorta March 2013 (d)
d. Coracohumeral ligament b. Oesophagus
c. Pulmonary trunk
71. Nerve lying in the spiral groove of humerus is:
d. Phrenic nerve
a. Musculocutaneous nerve September 2009
11
81. Bifurcation of trachea is at the level of lower border 90. If the circumflex artery gives off the posterior
of: March 2013 (e) interventricular artery, then the arterial supply is
a. T1 called: March 2007, March 2013 (f)
b. T2 a. Right dominance
c. T3 b. Left dominance
d. T4 c. Balanced dominanace
82. The order of neurovascular bundle in the intercostal d. None of the above
space from above downwards is:- March 2005 91. Constrictions in esophagus are seen at all the levels
a. VAN except: March 2007
b. ANV a. At the begining of esophagus
c. AVN b. At the site of crossing of esophagus by aortic arch
d. VNA c. Where esophagus pierces the diaphragm
83. Inhaled forgein body usually lodges in the: d. At the point of crossing of thoracic duct
a. Apex of right lung September 2007 92. Commonest location of diaphragmatic (bochdalek)
b. Lower lobe of right lung hernia in childrens is: March 2007
c. Apex of left lung a. Retrosternal
d. Lower lobe of left lung
b. Posterior and left
84. Normal Fluid level in the pericardial cavity: c. Posterior and right
a. 50 ml September 2005 d. Central
b. 100 ml
93. Which of the following does not drain into coronary
c. 150 ml
sinus: March 2009
d. 200 ml
a. Anterior cardiac vein
85. Right common carotid artery arises from: b. Small cardiac vein
a. Right axillary artery September 2005
c. Middle cardiac vein
b. Arch of aorta
d. Great cardiac vein
c. Brachiocephalic artery
d. Left subclavian artery 94. True about Thoracic part of sympathetic trunk:
September 2007
86. Bifurcation of trachea is at which level: September 2006
a. The first five ganglia give preganglionic fibers
a. Opposite the disc between the T3-T4 vertebrae
b. The sympathetic trunk has 13 segmentally arranged
b. Opposite the disc between the T5-T6 vertebrae
ganglia
c. Opposite the disc between the T4-T5 vertebrae
d. Opposite the disc between the T7-T8 vertebrae c. It is the most medially placed structure in the
mediastinum
87. Branches of left coronary artery are all of the following
d. The first ganglion is often fused with the inferior
except: September 2006
cervical ganglion to form the stellate ganglion
a. Anterior interventricular branch
b. Left diagonal artery 95. Length of esophagus in adults is: September 2005
c. Left atrial artery March 2013 (a, f)
d. Posterior interventricular branch a. 25 cm
b. 10 cm
88. True about arch of aorta are all of the following
except: March 2007 c. 15 cm
a. Situated behind the lower half of the manubrium d. 20 cm
sterni 96. Base of the heart is formed mainly by: September 2008
b. Right common carotid artery arises from the arch of a. Right atrium
aorta b. Left atrium
c. It ends at the sternal end of the left second costal c. Right ventricle
cartilage d. Left ventricle
d. Begining and end of the arch lies at same level 97. In mid clavicular plane, lower border of lung lies at
89. Structures passing through diaphragm through aortic level of: September 2008
hiatus are all except: March 2007, March 2013 (d, e) a. 4th rib
a. Aorta b. 6th rib
b. Azygous vein c. 8th rib
c. Thoracic duct d. 10th rib
d. Hemiazygous vein
12
Anatomy
98. Shape of tracheal cartilage: September 2008 INFERIOR EXTREMITY

a. W shaped
b. O shaped 108. To give intramuscular injections, safe quadrant of
c. C shaped gluteal region is: September 2004
d. D shaped a. Anterosuperior
99. Arterial supply to SA node is by: March 2009 b. Anteroinferior
a. Left anterior descending coronary artery c. Posterosuperior
b. Posterior interventricular (descending) artery d. Posteroinferior
c. Left coronary artery 109. Nerve supply of adductor magnus is through:
d. Right coronary artery September 2004
100. Muscles involved in quiet expiation: September 2009 a. Tibial part of sciatic nerve
a. Diaphragm b. Obturator nerve
b. Intercostal muscles c. Both
c. Both of the above d. None
d. None of the above 110. Saphenous nerve is a branch of: September 2004
101. Azygous vein drains into: September 2009 a. Tibial nerve b. Sciatic nerve
a. Right subcostal vein c. Common peroneal nerve
b. Superior vena cava d. Femoral nerve
c. Braciocephalic 111. Structure forming medial boundary of femoral ring
d. Right ascending lumbar vein is: September 2004
102. Cardiac dominance is determined by coronary artery: a. Inguinal ligament b. Pecten pubis
September 2009, March 2013 (a) c. Lacunar ligament d. Conjoint tendon
a. Supplying circulation to the SA node 112. Talus bone articulates with all of the following
b. Supplying circulation to the inferior portion of the EXCEPT: March 2013 (d)
interventricular septum a. Calcaneum
c. Supplying circulation to the interatrial septum b. Tibia
d. Supplying circulation to the anterior portion of the c. Navicular
interventricular septum d. Cuboid
103. SVC syndrome is most commonly associated with: 113. Inversion and eversion occurs at: March 2005
a. Mediastinal fibrosis September 2009 a. Subtalor joints
b. Lymphoma b. Ankle joint
c. Lung cancer c. Inferior Tibiofibular joint
d. TB mediastinitis d. All of the above
104. Arch of aorta begins and ends at which level: 114. Vein used in bypass Surgery: September 2005
a. T2 September 2010 a. Great saphenous vein
b. T3 b. Short saphenous vein
c. T4 d. T5 c. Femoral vein
105. Which of these does not form the right border of the d. Brachial vein
heart on X-ray: March 2011, March 2013 (g) 115. Muscles taking origin from ischial tuberosity are all
a. Right atrium except : March 2006
b. Arch of aorta a. Adductor longus
c. Superior vena cava b. Semimembranosus
d. Inferior vena cava
c. Semitendinosus
106. Structure passing through the central tendon of d. Adductor magnus
diaphragm is: March 2011
116. All of the following statements regarding the deep
a. Esophagus
fascia of the thigh are true except: March 2008
b. Right Phrenic nerve
a. It splits in the gluteal region to enclose gluteus
c. Subcostal nerve
maximus muscle
d. Left phrenic nerve
b. Iliotibial tract forms a sheath for tensor fasciae latae
107. Azygos vein drains into: September 2011 muscle
a. Left brachiocephalic vein c. Medially the fascia is thickened to form iliotibial
b. Inferior vena cava tract
c. Superior vena cava
d. It is also known as fascia lata
d. Right brachiocephalic vein
13
117. True regarding relationship of sac in femoral hernia 127. Sympathetic innervation to appendix is derived
with the pubic tubercle : September 2009 from: March 2003
a. Above and lateral a. D8
b. Below and lateral b. D10
c. Above and medial c. D12
d. Below and medial d. L1
118. Femoral pulsation can be best felt at: March 2011 128. Appendix posses: March 2003
a. Below and medial to pubic tubercle a. Taeniae coli
b. Near Anterior superior Iliac Spine b. Appendicis epiploicae
c. Mid point of inguinal ligament c. Sacculations
d. Mid-inguinal point d. Mesentery
119. Housemaids knee is an inflammation of: March 2011 129. Internal pudendal artery gives rise to: September 2003
a. Lateral patellae bursa a. Superior rectal artery
b. Semimembranosus bursa b. Middle rectal artery
c. Prepatellar bursa c. Inferior rectal artery
d. Suprapatellar bursa d. Median sacral artery
120. Housemaid knee is an inflammation of: September 2011 130. McBurneys point corresponds to which part of
a. Lateral bursa appendix: September 2003
b. Prepatellar bursa a. Tip
c. Suprapatellar bursa b. Base
d. Anserine bursa c. Orifice
d. Mid portion
ABDOMEN 131. Arterial supply of caecum is through: September 2003
a. Right colic artery
121. Development of human kidney begins in: March 2002 b. Middle colic artery
a. Dorsal region c. Ileocolic artery
b. Lumbar region d. All of the above
c. Thoracolumbar region 132. Which of the following is a retroperitoneal structure:
d. Sacral region September 2003
122. Length of ureter is: September 2002 a. Caecum
a. 15 cm b. Transverse colon
b. 20 cm c. Descending colon
c. 25 cm d. Sigmoid colon
d. 30 cm 133. Length of large intestine is: September 2003
123. Horse shoe kidney lies below the level of: a. 1.5 metres
a. Coeliac trunk September 2002 b. 3 metres
b. Superior mesenteric artery c. 4.5 metres
c. Inferior mesenteric artery d. 6 metres
d. Median sacral artery
134. Uterine artery is a branch of: March 2012
124. Extent of kidney is from: September 2002 a. Anterior internal iliac artery
a. D10-L1 b. Abdominal artery
b. D11-L2 c. Posterior internal iliac artery
c. D12-L3 d. Ovarian artery
d. L1-L3
135. All of the following forms visceral relations of the
125. Superior suprarenal artery originates from: spleen except: March 2012
a. Abdominal aorta September 2002 a. Fundus of stomach
b. Renal artery b. Duodenum
c. Inferior phrenic artery c. Left kidney
d. Splenic artery
d. Splenic flexure of colon
126. Spleen develops from: September 2002
136. Internal spermatic fascia is derived from:
a. Foregut diverticulum
a. External oblique aponeurosis September 2012
b. Dorsal mesogastrium
b. Internal oblique fascia
c. Pleuroperitoneal membrane
c. Fascia transversalis
d. Septum transversum
d. All of the above
14
Anatomy
137. NOT a constituent of spermatic cord: September 2012 147. Which of the following doesnt prevent prolapse of
a. Ducts deferens uterus: March 2005, March 2013 (f)
b. Testicular artery a. Perineal body
c. Ilio-inguinal nerve b. Pubocervical ligament
d. Genital branch of genitofemoral nerve c. Broad ligament
138. Structure passing through lesser sciatic notch: d. Transverse cervical ligament
September 2012, March 2013 148. Superficial inguinal lymph nodes drain from all of the
a. Tendon of obturator internus following except: September 2005
b. Superior gluteal vessels a. Urethra
c. Superior gluteal nerve b Anal canal below the pectinate line
d. Inferior gluteal nerve c. Glans penis
139. Lateral wall of ischiorectal fossa is formed by all d. Perineum
EXCEPT: September 2012 149. Gerotas fascia is: September 2005
a. Levator ani a. Renal fascia
b. Obturator internus b. Fibrous capsule
c. Ischial tuberosity c. Layer of perirenal fat
d. Obturator fascia d. Layer of pararenal fat
140. All of the following ligaments supports uterus 150. Superficial inguinal ring is a defect in the:
EXCEPT: March 2013 (a, f) September 2005
a. Urogenital diaphragm a. Internal oblique aponeurosis
b. Infundibulopelvic ligament b. External oblique aponeurosis
c. Ligaments of Mackenrodt c. Transverse abdominis aponeurosis
d. Pelvic diaphragm d. Internal oblique muscle
141. Left ovarian vein drains into: March 2013 (b) 151. Pouch of Douglas is between:
a. Common iliac vein September 2006, March 2013 (g)
b. Left renal vein a. Rectum and Sacrum
c. Inferior vena cava b. Uterus and Urinary bladder
d. Internal iliac vein c. Bladder and pubis symphysis
142. Constrictions in ureter are seen at all of the following d. Rectum and Uterus
sites EXCEPT: March 2013 (d) 152. Left testicular vein drains into:
a. At the pelviureteric junction a. Inferior vena cava September 2006, March 2013 (b)
b. At the brim of lesser pelvis b. Left renal vein
c. At the crossing by external iliac artery c. Portal vein
d. Passage through bladder wall d. Superior vena cava
143. True for vagina: March 2013 (g) 153. Which of the following is not supplied by Superior
a. Lined by columnar epithelium mesenteric artery: March 2007
b. Anterior fornix is deepest a. Jejunum
c. Lacks mucus secreting glands b. Appendix
d. Anterior wall is long as compared to posterior c. Ascending colon
144. Length of small intestine is: March 2013 (g) d. Descending colon
a. 4 metres 154. Blood supply of the uterus is by: March 2007
b. 6 metres a. Ovarian artery
c. 9 metres b. Uetrine artery
d. 10 metres c. Both
145. Diameter of female urethra is: March 2013 (h) d. None of the above
a. 3 mm 155. Pudendal nerve is related to: March 2007
b. 4 mm a. Ischial spine
c. 5 mm b. Sacral promontory
d. 6 mm c. Iliac crest
146. All are branches of Internal Iliac artery except: d. Ischial tuberosity
a. Ovarian artery March 2005 156. Kidney is supported by all of the following except:
b. Superior vesical artery a. Perirenal fat March 2007
c. Middle rectal artery b. Renal fascia
d. Inferior vesical artery c. Pararenal fat
d. Fibrous capsule
15
157. Uterine artery is a branch of: b. Superficial inguinal lymph nodes

March 2007 March 2012, March 2013 (d, h) c. Deep inguinal lymph nodes
a. Abdominal aorta d. Internal iliac lymph nodes
b. External iliac artery 167. Source of arterial supply to testis: March 2008
c. Femoral artery a. Internal pudendal artery
d. Internal iliac artery b. Deep external pudendal artery
158. Superficial inguinal ring in the female transmits: c. Superficial external pudendal artery
a. Broad ligament of uterus March 2007 d. Testicular artery
b. Round ligament of the uterus 168. True about uterus are all except: September 2008
c. Cardinal ligament a. Normally the uterus is retroverted
d. None of the above b. Angle of anteflexion is 125 degree
159. Regarding kidney, all of the following statements are c. Long axis of uterus corresponds to the axis of pelvic
true except: September 2007 inlet
a. They lie at the vertebral level T12 to L3 d. Posterior surface is related to the sigmoid colon
b. Retroperitoneal organ
169. Spleen is supported by all of the following except:
c. Left kidney is situated lower than the right
a. Phrenicocolic ligament September 2008
d. Left kidney is located slightly more medial than the
b. Gastrosplenic ligament
right
c. Lineorenal ligament
160. True about fallopian tubes are all except : d. Ligamentum teres
a. Lined by cuboidal epithelium September 2007
170. True about ureters are all except: March 2009
b. Isthmus is the narrower part of the tube that links to
a. Constricted at three places
the uterus
c. Tubal ostium is the point where the tubal canal b. It is 25cm long
meets the peritoneal cavity c. Testicular vessels lie anteriorly to the ureters
d. Mllerian ducts develops in females into the d. It is lined by cuboidal epithelium
Fallopian tubes 171. Not present at the transpyloric level: March 2009
161. Short gastric arteries are branches of: September 2007 a. Neck of pancreas September 2012
a. Celiac artery b. Fundus of stomach
b. Splenic artery c. Left and right colic flexure
c. Left gastroepiploic artery d. L1 vertebra
d Left gastroepiploic artery 172. Structures lying posterior to spleen are all of the
162. Ovarian artery is a branch of: September 2007 following except-: September 2009
a. Renal artery March 2013 (c, d, f, g, h) a. 11th rib
b. Internal iliac artery b. Left lung
c. Abdominal part of the aorta c. The diaphragm
d. External iliac artery d. The stomach
163. Commonest position of appendix: 173. All of the following veins lack valves except
September 2007 and 2010, March 2013 (c) a. Femoral vein September 2009
a. Pelvic b. Portal vein
b. Retrocaecal c. IVC
c. Subcaecal d. Dural venous sinuses
d. Promontoric 174. Normal Portal venous pressure is: March 2011
164. Veins draining into portal vein are all except: a. 5-10 mm Hg
September 2007 b. 10-15 mm Hg
a. Renal vein b. Splenic vein c. 15-20 mm Hg
c. Left gastric vein d. 20-255 mm Hg
d. Superior mesenteric vein 175. Renal angle lies between: March 2011
165. All of the following structures forms the stomach bed a. 12th rib and lateral border of sacrospinalis
except: March 2008, September 2012, March 2013 (e, h) b. 11th rib and lateral border of quadratus lumborum
c. 11th rib and lateral border of sacrospinalis
a. Hepatic flexure of colon
d. 12th rib and lateral border of quadratus lumborum
b. The left kidney
176. All of the following are components of urogenital
c. The pancreas
diaphragm except: March 2011, March 2013 (c, d, h)
d. Transverse mesocolon a. Sphincter urethrae
166. Lymphatic drainage of ovary is through: March 2008 b. Superficial transverse perineii
a. Preaortic and para-aortic lymph nodes c. Deep transverse perineii
d. Superficial fascia of urogenital diaphragm
16
Anatomy
177. Vaginal fornix is related to which of the following: c. V cranial nerve

a. Morisons pouch September 2011 d. VI cranial nerve
b. Pouch of Douglas
187. Muscle which dilates the palpebral aperture:
c. Intersigmoid recess
d. All of the above a. Orbicularis oculi September 2012
b. Orbicularis oris
HEAD AND NECK c. Levator palpebrae superioris
d. Levator labii superioris
178. Which of the following is associated with special 188. Action of ciliary muscle: September 2012
somatic afferent nuclei: March 2012 a. Constriction of pupil
a. Cranial nerve V b. Dilatation of pupil
b. Cranial nerve VI c. Change in shape of lens
c. Cranial nerve VII d. All of the above
d. Cranial nerve VIII
189. Muscle which helps in opening of the mouth:
179. All of the following are related to facial nerve except:
a. Lateral pterygoid September 2012
a. Maxillary processes March 2012
b. Medial pterygoid
b. Posterior belly of digastric muscle
c. Stylomastoid foramen c. Temporalis
d. Parotid gland d. Masseter
180. Trochlear and abducent nerve pass through: 190. Stapedius is supplied by: March 2013 (a, f)
a. Optic canal March 2012 a. Trigeminal nerve
b. Superior orbital fissure b. Abducent nerve
c. Inferior orbital fissure c. Facial nerve
d. Infraorbital foramen d. Vestibulocochlear nerve
181. Parotid duct opens: March 2012 191. If there is a superficial cut in the region of middle part
a. Floor of the mouth of posterior triangle of neck, patient will experience
b. Opposite lower second molar tooth problem in: March 2013 (e, h)
c. Opposite upper second molar tooth a. Adduction of arm
d. At epiglottis border b. Pronating scapula
182. True regarding opening of auditory tube in c. Shrugging of shoulder
nasopharynx is: March 2012 d. Abduction of arm
a. Posterior to inferior nasal concha 192. Main function of superior oblique is:
b. Posterior to middle nasal concha a. Adduction March 2013 (d, f)
c. Superior to inferior nasal concha b. Elevation
d. Inferior to inferior nasal concha c. Extortion
183. Safety muscle of larynx: March 2012 d. Intorsion
a. Lateral cricoarytenoid 193. Muscle which helps to open Eustachian tube while
b. Transverse arytenoid sneezing: March 2005, September 2010
c. Posterior cricoarytenoid a. Tensor veli palatini
d. Cricothyroids b. Levator veli palatini
184. Action of superior rectus: September 2012 c. None of the above
a. Abduction and intortion d. Both A and B
b. Adduction and extortion 194. Superior thyroid artery originates from:
c. Adduction and intortion a. Internal carotid artery September 2005
d. Abduction and extortion b. External carotid artery
185. Muscle supplied by glossopharyngeal nerve: c. Facial artery
a. Platysma September 2012 d. Maxillary artery
b. Stylopharyngeus 195. Recurrent laryngeal nerve supplies all of the following
c. Styloglossus muscles except: September 2005
d. Genioglossus a. Cricothyroid
b. Lateral cricoarytenoid
186. Lateral rectus is supplied by: September 2012
c. Posterior cricoarytenoid
a. III cranial nerve
d. Thyroepiglotticus
b. IV cranial nerve
17
196. True about pharyngeal diverticula are all except: a. Inferior rectus
September 2005 b. Medial rectus
a. Results due to neuromuscular incoordination c. Lateral rectus
b. Lies in the anterior wall of pharynx d. Superior oblique
c. They are normal in pig 207. Elevation of jaw is done by all except: September 2007
d. Food may get accumulated a. Temporalis
197. Number of parathyroid glands in human: b. Masseter
a. 4 September 2005 c. Lateral pterygoids
b. 3 d. Medial pterygoids
c. 2 208. Structure not passing through the superior orbital
d. 5 fissure: September 2007
198. Nasolacrimal duct opens in: a. Superior ophthalmic vein
September 2005, March 2013 (b, g) b. Trochlear nerve
a. The mouth opposite upper 2nd molar c. Abducent nerve
b. Middle meatus of nose d. Zygomatic nerve
c. Superior meatus of nose 209. All of the folowing opens into middle meatus except:
d. Inferior meatus of nose a. Middle ethmoidal air sinuses September 2007
199. Not a branch of external carotid artery: September 2006 b. Maxillary sinus
a. Inferior thyroid artery c. Posterior ethmoid sinuses
b. Facial artery d. Frontal air sinus
c. Superior thyroid artery 210. Branches of external carotid artery are all except:
d. Maxillary artery a. Maxillary artery September 2007
200. False about facial muscles: March 2007 b. Ascending pharyngeal artery
a. Dilates and constrict facial orifices c. Superior thyroid artery
b. Supplied by facial nerve d. Ophthalmic artery
c. Develops from 3rd pharyngeal arch
211. The facial nerve controls all of the following functions
d. They develop from mesoderm
except: March 2008
201. Motor supply to the muscles of the tongue is by: a. Intensity of the sound reaching the ear
a. Hypoglossal nerve March 2007 b. Lacrimation
b. Facial nerve c. Salivation
c. Lingual nerve d. Swallowing
d. Glossopharyngeal nerve 212. All of the following structures are within the parotid
202. Name of the parotid duct: March 2007 gland except: March 2008, March 2013 (c)
a. Stensons duct a. Facial artery
b. Nasolacrimal duct b. Facial nerve
c. Whartons duct c. External carotid artery
d. None of the above d. Retromandibular vein
203. Parotid duct passes through all the following 213. Which cranial nerve supplies parasympathetic
structures except: March 2007 secretomotor fibres to the submandibular salivary
a. Buccopharyngeal fascia gland: March 2008
b. Buccinator a. Vagus
c. Buccal fat pad b. Trigeminal
d. Masesster c. Facial
204. Thinnest part of scelra is: March 2007 d. Glossopharyngeal
a. At the entrance of optic nerve 214. All of the following are contents of the posterior
b. Site of entrance of ciliary nerves triangle of the neck except: March 2008
c. Corneoscleral junction a. Spinal part of accesory nerve
d. At the insertion of recti muscles b. Trunks of brachial plexus
205. Cadaver like position of vocal cords is seen in: c. Internal jugular vein
a. Both superior laryngeal nerve palsy March 2007 d. Transverse cervical artery
b. Both recurrent laryngeal nerve palsy 215. Muscle responsible for intorsion of the eye:
c. Both external laryngeal nerve palsy a. Superior oblique September 2008
d. Both internal laryngeal nerve palsy b. Superior rectus
c. Both of the above
206. Which of the following extraocular muscles does not
d. None of the above
arise from annulus: September 2007
18
Anatomy
216. Length of the cartilaginous part of Eustachian tube: d. Mylohyoid

a. 15 mm September 2008 226. Tendon of which muscle passes through the pyramid
b. 20 mm in middle ear: March 2010
c. 25 mm a. Incus
d. 30 mm b. Stapedius
217. The nerve that may get injured during removal of c. Malleus d. Tensor veli palatine
third molar is : March 2009 227. Which of the following nerve does not supply
a. Hypoglossal nerve submandibular gland: September 2010
b. Facial nerve a. Lingual nerve
c. Lingual nerve b. Chorda tympani
d. Glossopharyngeal nerve c. Sympathetic plexus
218. Parotid duct opens opposite to: March 2009, March 2012 d. Auriculotemporal nerve
a. Upper 1st molar 228. Which muscle is an abductor of the vocal cords:
b. Upper 2nd molar March 2011, September 2012, March 2013 (a, f)
c. Upper 2nd premolar a. Oblique Arytenoid
d. Upper 1st premolar b. Transverse Arytenoid
219. Function of superior oblique muscle is: March 2009 c. Lateral Thyroarytenoid
a. Intorsion, adduction and depression d. Posterior Cricoarytenoid
b. Intorsion, abduction and elevation 229. The palatine tonsil receives its arterial supply from all
c. Intorsion, abduction and depression of the following except: March 2011
d. Extorsion, abduction and depression a. Facial artery
220. Safety muscle of tongue is: March 2009, September 2010 b. Dorsal lingual artery
a. Styloglossus c. Superior thyroid artery
b. Genioglossus d. Ascending Palatine artery
c. Palatoglossus 230. Sensory nerve supply of the palatine tonsils is by:
d. Hyoglossus a. Greater Palatine nerve March 2011
221. Sensory nerve supply to angle of jaw is through: b. Trigeminal nerve
a. Great auricular nerve March 2009 c. Glossopharyngeal nerve
b. Buccal branches of facial nerve d. Facial nerve
c. Lesser petrosal nerve 231. Which of the following nerves carries taste sensation
d. Auriculotemporal nerve from posterior one-third of the tongue: March 2011
222. Vocal cord abductors is: a. Facial nerve March 2013 (c)
March 2009 and 2010; September 2009 b. Chorda tympani
a. Lateral cricoarytenoid c. Glossopharyngeal nerve
b. Posterior cricoarytenoid d. Vagus nerve
c. Cricothyroid 232. Internal jugular vein is the continuation of which of
d. Thyroarytenoid the following sinus: September 2011
223. The muscle which is not supplied by recurrent a. Cavernous sinus
laryngeal nerve is: September 2009 b. Sigmoid sinus
a. Thyroarytenoid c. Inferior petrosal sinus
b. Posterior cricoarytenoid d. Superior petrosal sinus
c. Cricothyroid 233. Scala tympani is supplied by which of the following
d. Lateral cricoarytenoid nerve: September 2011
224. Facial nerve does not supply which structure of a. Abducent nerve
theface: March 2010 b. Facial nerve
a. Auricular muscle c. Vestibulocochlear nerve
b. Posterior belly of diagastric muscle d. Glossopharyngeal nerve
c. Parotid gland 234 Oculomotor nerve supplies all muscles of the eye
d. Submandibular gland except: September 2011, March 2013 (g)
225. Muscle involved in congenital torticollis: March 2010 a. Inferior oblique
a. Deltoid b. Superior oblique
b. Sternocleidomastoid c. Superior rectus
c. Digastric d. Inferior rectus
19
BRAIN AND SPINAL CORD b. Trigeminal

c. Oculomotor
d. Vagus
235. Spinal cord in children ends at the lower border of:
a. L1 March 2012 245. Not a tributary of cavernous sinus: March 2007
b. L2 a. Superior petrosal sinus
c. L3 b. Sphenoparietal sinus
d. L4 c. Inferior ophthalmic vein
d. Superficial middle cerebral veins
236. Middle meningeal artery arises from: March 2013 (c)
a. Middle cerebral artery 246. Nuclei deep within the medial temporal lobes of the
b. Superior temporal artery brain: September 2007
c. Facial artery a. Amygdala
d. Maxillary artery b. Raphae nucleus
c. Dentate nucleus
237. CSF is obtained from space between: March 2013 (f)
d. Red nucleus.
a. Dura and arachnoidmater
b. Dura and pia mater 247. Cross section of midbrain at the level of superior
c. Arachnoid and pia mater colliculus shows : September 2009
d. None of the above a. Red nucleus and trochlear nerve nucleus
b. Rednucleus and abducent nerve nucleus
238. True regarding 3rd cranial nerve nuclei is: March 2013 (f) c. Red nucleus and optic nerve nucleus
a. Fibre for constrictor pupillae originate from Edinger
d. Red nucleus and occulomotor nerve nucleus
Westphal nucleus
b. Situated in dorsal side of the midbrain 248. Spinal part of accesory nerve supplies: March 2009
c. Connected to pretectal nuclei only on one side a. Pectoralis major
d. Lie at the level of inferior colliculus b. Pectoralis minor
c. Sternocleidomastoid
239. Arterial supply to dura mater is from all of the
d. Deltoid
following except: September 2005
a. Middle meningeal artery 249. Primary auditory area is: March 2009
b. Internal carotid artery a. Inferior temporal gyrus
c. Ascending pharyngeal artery b. Occiptal cortex
d. Basilar artery c. Superior temporal gyrus
240. Artery supplying major part of superolateral surface d. Frontal cortex
of brain is: September 2005 250. A lesion involving upper motor neuron of facial nerve
a. Middle cerebral artery manifests as: March 2009
b. Anterior cerebral artery a. Upper half of the face is affected, lower half normal
c. Posterior cerebral artery b. Left half of the face
d. Vertebral artery c. Right half of the face
241. In adults, spinal cord ends at the lower end of: d. Upper half of the face normal, lower half affected
September 2005, March 2013 (a, f) 251. Nucleus ambiguus is not associated with which
a. L2 cranial nerve: March 2010, March 2013 (f)
b. L4 a. X
c. L1 b. XI
d. L3 c. IX
242. Hypoglossal nerve is: September 2005 d. XII
a. 6th nerve 252. In neonates, spinal cord ends at:
b. 7th nerve
March 2010 and 2012, March 2013 (g)
c. 12th nerve
a. L1
d. 9th nerve
b. L2
243. Eye ball movements are controlled by all of the c. L3
following cranial nerves except: September 2005 d. L4
a. Optic nerve
b. Abducens nerve 253. Not involved in damage to cerebellum: March 2010
c. Trochlear nerve a. Posture
d. Oculomotor nerve b. Equiibrium
c. Asthenia
244. Largest cranial nerve is: September 2006
d. Tone
a. Trochlear
20
Anatomy
JOINTS 258. Which of the following is a multipennate muscle:

a. Rectus femoris March 2012
254. Abduction of the thigh is limited by : September 2009 b. Deltoid
a. Ischiofemoral ligaments c. Flexor pollicis longus
b. Pubofemoral ligaments d. Temporalis
c. Iliofemoral ligaments 259. True regarding elastic cartilage are all EXCEPT:
d. Sacroiliac ligament a. Made up of yellow elastic fibres March 2013 (d)
255. Ligament resisting hyperextension of hip are all b. More pliable
except: September 2009, March 2013 (c) c. Highly vascular
a. Ischiofemoral ligament d. Found in inlet of larynx
b. Pubofemoral ligament 260. Auricle of the ear is made of: March 2007,
c. Iliofemoral ligament a. Hyaline cartilage March 2013 (g)
d. Sacroiliac ligament b. Fibrocartilage
256. Unlocking of knee is done by which muscle: c. Elastic cartilage
September 2009, March 2013 (d, e, h) d. None of the above
a. Adductor magnus 261. Elastic cartilage is absent in: March 2011,
b. Biceps femoris a. Epiglottis March 2013 (a)
c. Popliteus b. Trachea
d. Sartorius c. External auditory canal
d. Auricle of the ear
MISCELLANEOUS 262. Arterio-venous anastomosis is not seen in: March 2011
a. Sympathetic ganglia
257. Which is a pneumatic bones: b. Tip of Nose
a. Clavicle March 2012 c. Finger tip
b. Maxilla d. Kidney
c. Humerus
d. Femur
21
ANSWERS WITH EXPLANATIONS

EMBRYOLOGY
1. Development of pulmonary veins

At 2729 days gestation, the primitive pulmonary vein appears as an endothelial out-pouching from either the
posterior superior left atrial wall or from the central part of the sinus venosus proximal to the primordial lung venous
plexus.
Connection between the primitive pulmonary vein and pulmonary venous plexus occurs by 30 days gestation.
The common pulmonary vein enlarges and incorporates into the left atrium, and, normally, the pulmonary venous
part of the splanchnic plexus gradually loses its connection with the cardinal and umbilicovitelline veins.
Ans. B i.e. Primitive left atrium
Ref: Langmans Embryology, 9th ed., p-175
2. Polar bodies
The first meiotic division of a primary oocyte produces 2 unequal daughters with haploid number of chromosomes
(23). The large cell is called the secondary oocyte and the smaller cell is known as first polar body.
The second meiotic is completed if fertilization occurs. This results in 2 unequal daughter cells. The smaller daughter
cell is called as second polar body.
Ans: C i.e. At the time of ovulation
Ref: IB Singh and GP Pals Embryology, 8th ed., p-15
3. Formation of primordial germ cells

Structures derived from neural crest are neurons of spinal posterior (dorsal) nerve root ganglia, neurons of sensory
ganglia of the 5 to 10th cranial nerves, neurons and satellite cells of sympathetic ganglia etc.
In the region where testes is to develop, the germinal epithelium gets thickened and is known as genital ridge.
The cells of germinal epithelium proliferate and forms sex cords which gets converted into medullary cords and
finally gets canalized to form seminiferous tubules
Chorion is formed by the parital/ somatopleuric extraembryonic mesoderm (on the inside) and the overlying
Trophoblast
The cells of the ovaries and the testes, from which germ cells are formed, are believed to be segregated early in the life
of the embryo.
They probably differentiate in the wall of the yolk sac.
Ans: D i.e. Yolk sac
Ref: IB Singh and GP Pals Embryology, 8th ed., p-259, 272
4. Mllerian ducts (or paramesonephric ducts)

They are paired ducts of the embryo that run down the lateral sides of the urogenital ridge and terminate at the
Mllerian eminence in the primitive urogenital sinus.
In the female, they will develop to form the Fallopian tubes, uterus, cervix, and the upper two-thirds of thevagina; in
the male, they are lost.
These ducts are made of tissue of mesodermal origin.
Ans. C i.e. Paramesonephric duct
Ref: Langmans Embryology 11th ed., p-253
5. Development of vagina
Upper part of the vagina derived from Mllerian ducts
Lower part from the sinovaginal bulbs (formed by fusion form the vaginal plate) all derived from the urogenital
sinus.
Ans. A i.e. Urogenital sinus
6. Implanatation
Implantation is the very early stage of pregnancy at which the embryo adheres to the wall of theuterus.
At this stage of prenatal development, the embryo is a blastocyst.
22
Anatomy
It is by this adhesion that the fetus receives oxygen and nutrients from the mother to be able to grow.
In humans, implantation of a fertilized ovum is most likely to occur about 9 days after ovulation, ranging between 6
to 12 days
Ans. C i.e. Blastocyst
7. Anterior belly of digastric is derived from first pharyngeal arch

Derivatives of 2nd pharyngeal arch
Stapes,
Styloid process,
Stylohyoid ligament, and
Lesser cornu of the hyoid bone.
Muscles of face
Occipitofrontalis muscle
Platysma
Stylohyoid muscle
Posterior belly of Digastric
Stapedius muscle
Auricular muscles
Ans. B i.e. Anterior belly of digastric
Ref: Langmans Embryology 11th ed., p-269t
8. The umbilical cord is surrounded by the fetal membrane, amnion, and contains Whartons jelly. Embedded in this jelly are
the:
Remains of the vitellointestinal duct and the allantois
Two umbilical arteries
One umbilical vein
The vein is a larger thin-walled vessel and is located at the 12 oclock position when facing the umbilicus; the two arteries,
which lie adjacent to one another and are located at the 4 and 8 oclock positions when facing the umbilicus, are smaller
and thick walled.
Ans. D: 2 arteries and 1 vein
Ref.: Langmans medical embryology, 9th ed., page-147
9. The ductus arteriosus represents the distal portion of the sixth left aortic arch and connects the left pulmonary artery
to the beginning of the descending aorta.
During fetal life, blood passes through it from the pulmonary artery to the aorta, thus bypassing the lungs. After
birth, it normally constricts, later closes, and becomes the ligamentum arteriosum.
A persistent patent ductus arteriosus results in high-pressure aortic blood passing into the pulmonary artery,
which raises the pressure in the pulmonary circulation.
A patent ductus arteriosus is life threatening and should be ligated and divided surgically.
Ans. A: Ductus arteriosus
Ref.: BDC 4th ed., vol.1, page-261, Clinical Anatomy-Snell, 8th ed., page-126
10. The fourth aortic arch persists on both sides, but its ultimate fate is different on the right and left sides.
On the left it forms part of the arch of the aorta, between the left common carotid and the left subclavian arteries.
On the right it forms the most proximal segment of the right subclavian artery, the distal part of which is formed by a
portion of the right dorsal aorta and the seventh intersegmental artery
Ans. C: Left fourth aortic arch artery
Ref.: BDC 4th ed., vol.1, page-263, Langmans medical embryology, 9th ed., page-256
11. The eyes begin to develop as a pair of outpocketings that will become the optic vesicles on each side of the forebrain
at the end of the fourth week of development.
The optic vesicles contact the surface ectoderm and induce lens formation.
When the optic vesicle begins to invaginate to form the pigment and neural layers of the retina, the lens placode
invaginates to form the lens vesicle.
Ans. B: Surface ectoderm
Ref.: BDC 4th ed., vol.3, page-277, Langmans medical embryology, 9th ed., page-426
23
12. Early in development, the embryonic mesoderm becomes differentiated into three distinct regions: paraxial mesoderm,
intermediate mesoderm, and lateral mesoderm.
The paraxial mesoderm gets divided into somites which gets differentiated into a ventromedial part (the sclerotome) and
a dorsolateral part (the dermatomyotome).
The dermatomyotome now further differentiates into the myotome and the dermatome.
The mesenchymal cells of the sclerotome rapidly divide and migrate medially during the fourth week of development and
surround the notochord.
The caudal half of each sclerotome now fuses with the cephalic half of the immediately succeeding sclerotome to form the
mesenchymal vertebral body.
Each vertebral body is thus an intersegmental structure. The notochord degenerates completely in the region of the
vertebral body, but in the intervertebral region, it enlarges to form the nucleus pulposus of the intervertebral discs.
The surrounding fibrocartilage, the anulus fibrosus, of the intervertebral disc is derived from sclerotomic mesenchyme
situated between adjacent vertebral bodies.
Ans. B: Nucleus pulposus
Ref.: Clinical Anatomy-Snell, 8th ed., page-875
13. With differential growth of the dorsal bladder wall, the ureters come to open through the lateral angles of the bladder, and
the mesonephric ducts open close together in what will be the urethra.
That part of the dorsal bladder wall marked off by the openings of these four ducts forms the trigone of the bladder.
Thus, lining of the bladder over the trigone is mesodermal in origin;
The smooth muscle of the bladder wall is derived from the splanchnopleuric mesoderm.
The apex of the bladder is continuous with the allantois, which now becomes obliterated and forms a fibrous core, the
urachus. The urachus persists throughout life as a ligament that runs from the apex of the bladder to the umbilicus and is
called the median umbilical ligament
Ans. A: Mesoderm
14. Fossa ovalis and anulus ovalis lie on the atrial septum, which separates the right atrium from the left atrium.
The fossa ovalis is a shallow depression, which is the site of the foramen ovale in the fetus. The anulus ovalis forms the
upper margin of the fossa. The floor of the fossa represents the persistent septum primum of the heart of the embryo, and
the anulus is formed from the lower edge of the septum secundum
Ans. B: Septum primum
15. The eardrum forms from the joining of the expanding first pharyngeal pouch and groove. Around day 30 of gestation, the
endoderm-lined first expands to form the tympanic cavity, which subsequently envelops the inner ear ossicles.
Simultaneously, the first pharyngeal groove, which is lined with ectoderm, expands to form the developing external
auditory meatus. Separated by a thin layer of splanchnic mesoderm, the tympanic cavity and external auditory meatus
join to form the tympanic membrane.
As a result, the tympanic membrane is derived from all three germ layers.
Ans. B: Tympanic membrane
Ref.: BDC 4th ed., vol.3, page-266
16. Diverticula are classified as true and false. True diverticula are composed of all layers of the intestinal wall, whereas
false diverticula are formed from the herniation of the mucosal and submucosal layers.
Diverticula can be classified as intraluminal or extraluminal.
Intraluminal diverticula and Meckels diverticulum are congenital
Extraluminal diverticula may be found in various anatomic locations and are referred to as duodenal, jejunal, ileal, or
jejunoileal diverticula.
Meckels diverticulum is a congenital anomaly representing a persistent portion of the vitellointestinal duct. It occurs in 2%
of patients, is located about 2 ft (61 cm) from the ileocolic junction, and is about 2 inch (5 cm) long.
It can become ulcerated or cause intestinal obstruction.
A Meckels diverticulum, a true congenital diverticulum, is a small bulge in the small intestine present at birth. It is a
vestigial remnant of the omphalomesenteric duct (also called the vitelline duct or yolk stalk) and is the most frequent
malformation of the gastrointestinal tract. It is present in approximately 2% of the population, with males more frequently
experiencing symptoms.
24
Anatomy
A memory aid is the rule of 2s: 2% (of the population) - 2 feet (from the ileocecal valve) - 2 inches (in length) - 2%
are symptomatic, there are 2 types of common ectopic tissue (gastric and pancreatic), the most common age at clinical
presentation is 2, and males are 2 times as likely to be affected.
Ans. B: Meckels diverticulum
Ref.: BDC 4th ed., vol.2, page-252,251. Clinical Anatomy-Snell, 8th ed., page-182
17. The boundaries of anatomical snuff box:

The medial border of the snuffbox is the tendon of the extensor pollicis longus.
The lateral border is a pair of parallel and intimate tendons, of the extensor pollicis brevis and the abductor pollicis
longus. (Accordingly, the anatomical snuffbox is most visible, having a more pronounced concavity, during thumb
extension.)
The proximal border is formed by the styloid process of the radius
The distal border is formed by the approximate apex of the schematic snuffbox isosceles triangle.
The floor of the snuffbox varies depending on the position of the wrist, but both the trapezium and primarily the
scaphoid can be palpated
Deep to the tendons which form the borders of the anatomical snuff box lies the radial artery, which passes through the
anatomical snuffbox on its course from the normal radial pulse detecting area, to the proximal space in between the first
and second metacarpals to contribute to the superficial and deep palmar arches.
Ans. C: Radial artery
Ref.: Snells Clinical Anatomy, 7th ed., p-533
18. The constituents of the umbilical cord when fully developed are covering epithelium, whartons jelly, blood vessels,
remnant of the umbilical vesicle (yolk sac) and its vitelline duct, allantois and obliterated extraembryonic coelom
Umbilical cord:
The umbilical cord develops from and contains remnants of the yolk sac and allantois.
It forms by the fifth week of fetal development, replacing the yolk sac as the source of nutrients for the fetus.
The length of the umbilical cord is approximately equal to the crown-rump length of the fetus throughout pregnancy.
The umbilical cord in a full term neonate is usually about 50 centimeters (20 in) long and about 2 centimeters (0.75 in)
in diameter.
The umbilical cord is composed of Whartons jelly, a gelatinous substance made largely from mucopolysaccharides.
It contains one vein, which carries oxygenated, nutrient-rich blood to the fetus, and two arteries that carry
deoxygenated, nutrient-depleted blood away.
Occasionally, only two vessels (one vein and one artery) are present in the umbilical cord.
The blood flow through the umbilical cord is approximately 35 ml / min at 20 weeks, and 240 ml / min at 40 weeks
of gestation.
Adapted to the weight of the fetus, this corresponds to 115 ml / min / kg at 20 weeks and 64 ml / min / kg at 40 weeks

Cloacal duct
It is a small communication between the 2 portions of the hindgut.
Down growth of the urorectal septum is believed to close this duct by 7 weeks gestation.
Ans. C: Cloacal duct
Ref.: Duttas Obstetrics, 7th ed., p-40
19. Umbilical vein carries oxygenated blood to embryo

Ans. B: Carry oxygenated blood towards the fetus
Ref.: IB Singhs Embryology, 7th ed., p-265
20. After birth, the left umbilical vein are obliterated and forms the ligamentum teres hepatis
Ligamentum teres
It is the obliterated fibrous remnant of the left umbilical vein of the fetus.
It originates at the umbilicus.
It passes superiorly in the free margin of the falciform ligament.
From the inferior margin of the liver, it may join the left branch of the portal vein or it may be in continuity with the
ligamentum venosum
Other fetal remnants
Umbilical arteries forms medial umbilical ligament
25
Ductus venosus forms ligamnetum venosusm

Ductus arteriosus forms ligamnetum arteriosum
Ans. B: Remnant of umbilical vein
21. Complete anatomical obliteration by proliferation of the intima is thought to take 1-3 months.
Patent ductus arteriosus (PDA)
Failure of a childs DA to close after birth results in a condition called patent ductus arteriosus and the generation of a
left-to-right shunt.
If left uncorrected, patency leads to pulmonary hypertension and possibly congestive heart failure and cardiac
arrhythmias.
Prostaglandins are responsible for maintaining the ductus arteriosus.
Closure may be induced with a drug class known as NSAIDs such as indomethacin or ibuprofen because these drugs
inhibit prostaglandin synthesis.
A patent ductus arteriosus affects around 40% of infants with Down syndrome (DS).
Changes in circulation after birth
The ductus arteriosus is occluded, so that all blood from the right ventricle now goes to the lungs, where it is
oxygenated.
Initial closure of the DA is caused by contraction of the muscle in the vessel wall
Later in 1-3 months intima proliferation obliterates the lumen
So looking at the choices, D option seems the best answer
Ans. D: 30 day
22. In 2-4% of people, a small portion of the vitelline duct persists, forming an outpocketing of the ileum, Meckels/ ileal diverticulum
Sometimes both ends of the vitelline duct transforms into fibrous cords, and the middle portion forms a large cyst, an enterocystoma/
vitelline cyst
Vitelline duct, ay remain patent over its entire length, forming a direct communication between the umbilicus and the intestinal tract
known as umbilical fistula/ vitelline fistula
Vitello-intestinal duct or omphalo-mesenteric duct connects the midgut to the yolk sac during early embryonic life and
gets obliterated and disappears during fifth to sixth week of intrauterine life. If the remnants persists then following
abnormalities can occur:
Umbilical Polyp: Umbilical polyp occur because of persistance of small portion of vitello-intestinal duct epithelium
at the base of umbilicus.
Umbilical Sinus: When umbilical portion of vitello-intestinal duct remains patent, an umbilical sinus forms.
Fibrous remnant of vitello-intestinal duct: Whole vitello-intestinal duct become fibrous strand but does not disappear.
Meckels/ Ileal Diverticulum: The ileal portion of vitello-intestinal duct remains patent and form a diverticulum,
called as Meckels diverticulum.
Patent Vitello-intestinal duct: When whole vitello-intestinal duct remains patent cause fistulous connection between
umbilicus and ileum (umbilical fecal fistula)
Mesenteric cyst
Mesenteric cyst are thought to represent benign proliferations of ectopic lymphatics that lack communication with the
normal lymphatic system.
Cysts are thought to arise from lymphatic spaces associated with the embryonic retroperitoneal lymph sac, making
them analogous to cystic hygromas, which arise in the neck in association with the jugular lymph sac.
Another proposed etiology is lymphatic obstruction
Mesenteric cysts can occur anywhere in the mesentery of the gastrointestinal tract from the duodenum to the
rectum, and they may extend from the base of the mesentery into the retroperitoneum
Ans. D: Mesenteric cyst
Ref.: Langmans Embryology, 11th ed., p-228
23. In the human, trophoblastic cells over the embryoblast pole begin to penetrate between the epithelial cells of the uterine
mucosa on about the 6th day
Implantation: The second week of human development is concerned with the process of implantation and the differentiation
of the blastocyst into early embryonic and placental forming structures.
Implantation commences about day 6
26
Anatomy
dplantation - begins with initial adhesion to the uterine epithelium (blastocyst then slows in motility, rolls on
A
surface, aligns with the inner cell mass closest to the epithelium and stops)
Implantation - migration of the blastocyst into the uterine epithelium, process complete by about day 9
Coagulation plug - left where the blastocyst has entered the uterine wall day 12
Normal Implantation Sites - in uterine wall superior, posterior, lateral
Ans. D: 6
Ref.: Langmans Embryology, 11th ed., p-41
24. Although initially only slightly motile, spermatozoa obtains full motility in the epididymis
Development of the sperm
Spermatogenesis is the process of spermatagonia (diploid) mature into spermatozoa (haploid).
Spermioogenesis is a part of spermatogenesis where round spermatids mature into the mature spermatozoa form.
Spermatozoa acquire some motility only after passing through the epididymis
The secretions of the epididymis, seminal vesicle and the prostate have a stimulating effect on sperm motility, but the
sperm becomes fully motile only after ejaculation
Continuously throughout life occurs in the seminiferous tubules in the male gonad-testis.
At puberty spermatagonia activate and proliferate (mitosis).
About 48 days from entering meiosis until morphologically mature spermatozoa
About 64 days to complete spermatogenesis, depending reproduction time of spermatogonia
Follicle stimulating hormone (FSH) - stimulates the spermatogenic epithelium
Luteinizing-hormone (LH) - stimulates testosterone production by Leydig cells
Stages of spermatozoa development
Spermatogonia - are the first cells of spermatogenesis
Primary spermatocytes - large, enter the prophase of the first meiotic division
Secondary spermatocytes - small, complete the second meiotic division
Spermatid - immature spermatozoa
Spermatozoa - differentiated gamete
Ans. D: Epididymis
Ref.: Langmans Embryology, 11th ed., p-30; Guytons Physiology, 10th ed., p-918
25. The genital tubercle elongates only slightly and forms the clitoris
Phallic tubercle or genital tubercle
Present in the development of the urinary and reproductive organs.
It forms in the ventral, caudal region of mammalian embryos of both sexes and eventually develops into a phallus.
In the human fetus the genital tubercle develops around week 4 of gestation and by week 9 becomes recognizably
either a clitoris or penis.
This should not be confused with the sinus tubercle which is a proliferation of endoderm induced by paramesonephic
ducts.
Even after the phallus is developed, the term genital tubercle remains, but only as the terminal end of it, which
develops into either the glans penis or the glans clitoridis.
Ans. A: Genital tubercle
HISTOLOGY
26. Epithelium
Columnar epithelium with a striated border is seen most typically in the small intestine, and with a brush border in
the gall bladder.
Transitional epithelium is found in the renal pelvis and calyces, the ureter, the urinary bladder, and part of the urethra.
A typical cuboidal epithelium may be seen in the follicles of the thyroid gland
Non-keratinized stratified Squamous epithelium is seen lining the mouth, the tongue etc.
Ans: B i.e. Urinary bladder
Ref: IB Singhs Histology, 5th ed., p-47, 48, 50
27
27. Epithelium
Keratinized stratified Squamous epithelium covers the skin of the whole of the body.
Non-keratinized stratified Squamous epithelium is seen lining the mouth, the tongue, the pharynx, the oesophagus,
the vagina and the cornea
Columnar epithelium with a striated border is seen most typically in the small intestine, and with a brush border in
the gall bladder
Ans: D i.e. Gall bladder
Ref: IB Singhs Histology, 5th ed., p-47, 50
28. Non-keratinized stratified Squamous epithelium is seen lining the mouth, the tongue, the pharynx, the oesophagus, the
vagina and the cornea
Ans. D i.e. Uterus
Ref: IB Singhs Histology, 6th ed., p-312
29. Types of non-keratinized stratified squamous epithelium include cornea, oral cavity, esophagus, anal canal and vagina
Ans. C i.e. Stratified squamous non-keratinized
30. Vagina
Vaginal lubrication is provided by the Bartholins glands near the vaginal opening and the cervix.
The membrane of the vaginal wall also produces moisture, although it does not contain any glands.
Before and during ovulation, the cervixs mucus glands secrete different variations of mucus, which provides an
alkaline environment in the vaginal canal that is favorable to the survival of sperm.
Ans. C i.e. Vagina
31. Epithelium of cervix

The epithelium of the cervix is varied.
The ectocervix (more distal, by the vagina) is composed of nonkeratinized stratified squamous epithelium.
The endocervix (more proximal, within the uterus) is composed of simple columnar epithelium.
Ans. B i.e. Stratified squamous epithelium
32. Pneumocytes
Two types of pneumocytes contribute to the maintenance of the alveoli of the lungs
Type I pneumocytes and Type II pneumocytes.
These cells function to aid in gas exchange, secretion of pulmonary surfactant, and self-regeneration
Ans. A i.e. Alveoli
33. Dense Regular Connective Tissue

In this type of tissue, the collagen fibres are densely packed, and arranged in parallel.
This type of tissue is found in ligaments (which link bone to bone at joints) and tendons (connections between bones
or cartilage and muscle).
These are powerfully resistant to axially loaded tension forces, but allow some stretch.
Ans. A i.e. Collagen fibres
34. Columnar epithelium

Ciliated pseudostratified columnar epithelia are found in the lines of the trachea as well as the upper respiratory tract.
Non-ciliated pseudostratified columnar epithelia are located in the membranous part of male vas deferens.
Pseudostratified columnar epithelia with stereocilia are located in the epididymis.
Ans. B i.e. Vas deferens
28
Anatomy
35. Ans. A: Nonkeratinized Stratified Squamous epithelium

36. Brunner glands (or Pancreal glands/duodenal glands) are compound tubular submucosal glands found in that portion
of the duodenum which is above the hepatopancreatic sphincter.
The main function of these glands is to produce a mucus-rich alkaline secretion (containing bicarbonate).
Ans. B: Duodenum
Ref.: BDC 4th ed., vol.2, page-251, IB Singh histology-5th ed-page-244
37. Layers of the retina, from the outside inwards

Retinal Pigment Epithelium
Layer of rods and cones
External (Outer) limiting membrane
Outer nuclear layer
Outer plexiform layer
Inner nuclear layer
Inner plexiform layer
Ganglion cell layer
Layer of optic nerve fibres
Internal (Inner) limiting membrane
The neural retina meets the optic nerve at the optic disc (or optic papilla), which is devoid of photoreceptor cells, forming
a blind spot in the visual field.
The fovea, lateral to the optic disc, is the area of greatest visual acuity, and is surrounded by a yellow pigmented zone
called the fovea lutea.
Bowmans membrane is present in cornea
Ans. C: Bowmans membrane
Ref.: BDC 4th ed., vol.3, page-275,271, IB Singh histology-5th ed-page-328
38. Cardiac muscle consists of striated muscle fibers that branch and unite with each other. It forms the myocardium of the
heart.
Its fibers tend to be arranged in whorls and spirals, and they have the property of spontaneous and rhythmic contraction.
Specialized cardiac muscle fibers form the conducting system of the heart.
Cardiac muscle is supplied by autonomic nerve fibers that terminate in the nodes of the conducting system and in the
myocardium.
Ans. C: Cardiac muscle cells are linear and longitudinal
Ref.: IB Singh histology-5th ed-page-132, Clinical Anatomy-Snell, 8th ed., page-12
39. Other sites with the typical cuboidal epithelium are:

Surface of ovary
Choroid plexus
Inner surface of lens
Pigment cell layer of retina
Ans. D: Thyroid gland
Ref.: IB Singh histology-5th ed-page-48
40. Hasals corpuscles /thymic corpuscles are structures found in the medulla of the human thymus, formed from type
VI epithelial reticular cells.
They are named for Arthur Hill Hassall, who discovered them in 1849.
Ans. A: Thymus
41. Blood-Testis Barrier a barrier separating the blood from the seminiferous tubules, consisting of special junctional
complexes between adjacent Sertoli cells near the base of the seminiferous epithelium.
Other barriers in the body:
Placental barrier term sometimes used for the placental membrane, because it prevents the passage of some materials
between the maternal and fetal blood.
29
Blood-aqueous barrier the physiologic mechanism that prevents exchange of materials between the chambers of the
eye and the blood.
Blood-brain barrier, blood-cerebral barrier the selective barrier separating the blood from the parenchyma of the
central nervous system. Abbreviated BBB
Ans. B: Sertoli cells
42. Continuos capillaries

Location: muscle, lung, central nervous system and skin.
Composition: endothelial cells contain numerous pinocytotic vesicles, pericytes are enclosed by a basement membrane.
Fenestrated Capillaries
Location: endocrine glands, sites of fluid and metabolite absorption: renal corpuscles, intestinal tract, and gallbladder.
Composition: endothelial cells contain fenestrations, 80-100 nm in diameter, those provide channels across the capillary
wall, pericytes are enclosed by a basement membrane.
Discontinuous capillaries (sinusoid)
Location: liver, spleen, and bone marrow.
Composition: endothelial cells with unusually wide gaps between them, partial or total absence of basement membrane.
Ans. D: Muscle
43. The goblet cells secrete mucus, a viscous fluid composed primarily of highly glycosylated proteins called mucins.
Goblet cells are found scattered among other cells in the epithelium of many organs, especially in the intestinal and
respiratory tracts.
They are present in trachea, bronchus and larger bronchioles in respiratory tract, small intestines, the colon and
conjunctiva in the upper eye lid
In some areas, their numbers are rather small relative to other cell types, while in tissues such as the colon, they are much
more abundant
Ans. D: Esophagus
Ref.: IB Singh histology-5th ed-page-47, 246
44. Peyers patches are observable as elongated thickenings of the intestinal epithelium measuring a few centimeters in length.
About 30 are found in humans.
Microscopically, Peyers patches appear as oval or round lymphoid follicles (similar to lymph nodes) located in the lamina
propria layer of the mucosa and extending into the submucosa of the ileum
Ans. C: Ileum
Ref.: DiFiores Histology, 11th ed.,p-300
45. In the white pulp, the T-cells areas surround the central arteries, forming the periarteriolar sheath (PALS)
White pulp
The white pulp consists of lymphatic tissue surrounding arteries and nodules also associated with arteries.
The nodules can be distinguished because of the arteries (central arteries).
The lymphatic tissue immediately surrounding the central artery is known as the periarterial lymphatic sheath (PALS)
and is composed of T-lymphocytes.
The more peripheral part of the nodules is known as the peripheral white pulp (PWP) and consists of aggregates of
B-lymphocytes.
Red pulp
The red pulp is like a sponge composed of cords of cells (splenic cords) and splenic sinusoids (venous sinusoids).
The splenic cords (Billroth cords) are composed of :
Reticular cells and fibers
Fixed and wandering macrophages
Lymphocytes
Plasma cells
Blood cells (erythrocytes, granulocytes) and pl
Ans. B: Spleen
Ref.: IB Singh histology-5th ed-page-132, Clinical Anatomy-Snell, 8th ed., page-12
30
Anatomy
46. The lining epithelium of uterus is columnar

Before menarche (the age of menstruation) the cells are ciliated, but thereafter most of the cells may not have cilia
Ciliated columnar epithelium
These cells are rectangular in shape and have between 200 to 300 hair-like protrusions called cilia T
The mitochondria are found toward the apical region of the cell while the cell nuceli are found towards the base and
are often elongated.
Cells are interconnected via desmosomses and tight junctions, creating a semipermeable membrane that is more
selective that membrane found in other types of cell.
Ciliated columnar epithelial cells are found mainly in the tracheal and bronchial regions of the pulmonary system and
also in the fallopian tubes of the female reproductive system.
Ans. A: Ciliated columnar epithelium
Ref.: IB Singh histology-6th ed-page-312,
SUPERIOR EXTREMITY
47. Contents of axilla

Axillary artery and its branches
Axillary vein and its tributaries
Infraclavicular part of brachial plexus
Five groups of axillary lymph nodes and the associated lymphatics
The long thoracic and intercostobrachial nerve
Axillary fat and areolar tissue in which the other contents are embedded
Lymph nodes of axilla are very important from pathological point of view because breast cancer in female spread to
these lymph nodes readily.
Ans. C i.e. Roots of brachial plexus
Ref: BDC-I, 5th ed., p-52
48. Lateral wall of the axilla is formed by the intertubercular sulcus of humerus
Boundaries of Axilla
1. Apex:
It is directed upwards and medially towards the root of the neck.
It is truncated (not pointed), and corresponds to a triangular interval bounded anteriorly by the clavicle, posteriorly
by the superior border of the scapula, and medially by the outer border of the first rib. This passage is called the
cervicoaxillary canal. The axillary artery and the brachial plexus enter the axilla through this canal.
2. Base or Floor
It is directed downwards, and is formed by skin, superficial and axillary fasciae.
3. Anterior Wall
It is formed by the following:
The pectoralis major in front.
The clavipectoral fascia enclosing the pectoralis minor and the subclavius; all deep to the pectoralis major.
4. Posterior Wall
Subscapularis above.
5. Medial Wall
Upper four ribs with their intercostal muscles.
Upper part of the serratus anterior muscle.
6. Lateral Wall
It is very narrow because the anterior and posterior walls converge on it. It is formed by the following:
Upper part of the shaft of the humerus in the region of the bicipital groove, and
Coracobrachialis and short head of the biceps brachii.
Teres major and latissimus dorsi below
31
Ans. D i.e. Lateral

49. Action of supraspinatus

Contraction of the supraspinatus muscle leads to abduction of the arm at the shoulder joint.
It is the main agonist muscle for this movement during the first 10-15 degrees of its arc.
Beyond 30 degrees the deltoid muscle becomes increasingly more effective at abducting the arm and becomes the
main propagator of this action
Ans. C i.e. Abduct the arm to horizontal level
Ref: BDC-I, 5th ed., p-78t
50. Boundaries of quadrangular space

Above/superior: the subscapularis and teres minor
Below/inferior: the teres major
Medially: the long head of the triceps brachii
Laterally: the surgical neck of humerus
Ans. B i.e. Teres minor
51. Upper Quadrangular space

It has the following boundaries:
the teres major inferiorly
the long head of the triceps laterally
For the superior border, some sources list the teres minor, while others list the subscapularis.
It contains the scapular circumflex vessels.
Ans. D i.e. Circumflex scapular artery
52. Superficial palmar arch

The superficial palmar arch is formed as the direct continuation of the ulnar artery beyond the flexor retinaculum
The proximal transverse crease lies at the level of wrist joint
The distal transverse crease corresponds to the proximal border of the flexor retinaculum
The most distal point of superficial palmar arch is situated at the level of the distal border of the fully extended thumb
Ans: B i.e. Below distal transverse crease of wrist
Ref: BDC, 3rd ed., Vol: I, p-94, 115, 148
53. Froment sign

To perform the test, a patient is asked to hold an object, usually a flat object such as a piece of paper, between their
thumb and index finger (pinch grip). The examiner then attempts to pull the object out of the subjects hands.
A normal individual will be able to maintain a hold on the object without difficulty.
However, with ulnar nerve palsy, the patient will experience difficulty maintaining a hold and will compensate by
flexing the FPL (flexor pollicis longus) of the thumb to maintain grip pressure causing a pinching effect.
Clinically, this compensation manifests as flexion of the IP joint of the thumb (rather than extension, as would occur
with correct use of the adductor pollicis).
The compensation of the affected hand results in a weak pinch grip with the tips of the thumb and index finger,
therefore, with the thumb in obvious flexion.
FPL is normally innervated by the anterior interosseous branch of the median nerve.
Ans. B i.e. Ulnar nerve
54. Winging of scapula

The most common cause of scapular winging is serratus anterior paralysis.
This is typically caused by damage to the long thoracic nerve.
This nerve supplies the serratus anterior, which is located on the side of the thorax and acts to pull the scapula forward.
Ans. C i.e. Nerve to serratus anterior palsy
32
Anatomy
55. Subclavius forms the anterior wall of axilla

Ans. B i.e. Subclavius
56. Ans. D i.e. Serratus anterior

57. Claw hand

Caused by imbalance between strong extrinsics and deficient intrinsics
Characterized by
MCP hyperextension
PIP and DIP flexion
Causes
Ulnar nerve injury
Cubital tunnel syndrome
Ulnar tunnel syndrome
Median nerve injury
Median nerve injury
Volkmanns ischemic contracture
Leprosy (Hansens disease
Failure to splint the hand in an intrinsic-plus posture following a crush injury
Charcot-Marie-Tooth disease (hereditary motor-sensory neuropathy)
Compartment syndrome of the hand
Ans. C i.e. Claw hand
58. Brachioradialis is supplied by radial nerve

Ans. D i.e. Brachioradialis
59. Suprascapular nerve arises from the upper trunk (formed by the union of the fifth and sixth cervical nerves).
Ans. A i.e. Suprascapular nerve
60. BRANCHES OF THE BRACHIAL PLEXUS
There are a total of 17 branches arising from the brachial plexus that are destined to supply the upper limb of the seventeen
branches of the brachial plexus; three of the branches arise from the root, one from the trunk, three from the lateral cord,
five from the medial cord and five from the posterior cord.
Branches from the roots
Long thoracic nerve of bell (C5, C6, C7).
Dorsal scapular nerve (C5).
Branches from the trunk
Suprascapular Nerve (C5, C6)
Nerve to subclavius (C5, C6)
Branches from the lateral cord
Lateral pectoral nerve. (C5, C6).
Musculocutaneous (C5, C6, C7)
Lateral root of median nerve (C5, C6, C7).
Branches from the medial cord
Medial pectoral nerve (C8, T1)
Medial cutaneous nerve of arm (C8,T1)
Medial cutaneous nerve of forearm (C8,T1)
Ulnar nerve(C7, C8, T1)
Medial root of median nerve (C8,T1)
Branches from the posterior cord
Axillary nerve (C5, C6)
Upper subscapular nerve (C5,C6)
Thoracodorsal nerve (C6, C7, C8).
33
Lower subscapular nerve (C5, C6)

Radial nerve (C5-T1).
Ans. D: C5, C6, C7, C8, T1
61. The ulnar artery is the larger of the two terminal branches of the brachial artery.
It begins in the cubital fossa at the level of the neck of the radius.
descends through the anterior compartment of the forearm and enters the palm in front of the flexor retinaculum in
company with the ulnar nerve.
It ends by forming the superficial palmar arch, often anastomosing with the superficial palmar branch of the radial
artery.
In the upper part of its course, the ulnar artery lies deep to most of the flexor muscles.
Below, it becomes superficial and lies between the tendons of the flexor carpi ulnaris and the tendons of the flexor
digitorum superficialis.
In front of the flexor retinaculum, it lies just lateral to the pisiform bone.
Branches
Muscular branches to neighboring muscles
Recurrent branches that take part in the arterial anastomosis around the elbow joint
Branches that take part in the arterial anastomosis around the wrist joint
The common interosseous artery, which arises from the upper part of the ulnar artery and after a brief course divides
into the anterior and posterior interosseous arteries.
Ans. C: Ulnar artery
62. Pectoralis major arises from the anterior surface of the sternal half of the clavicle; from breadth of the half of the anterior
surface of the sternum, as low down as the attachment of the cartilage of the sixth or seventh rib; from the cartilages of
all the true ribs, with the exception, frequently, of the first or seventh and from the aponeurosis of the abdominal external
oblique muscle. From this extensive origin the fibers converge in a flat tendon, about 5 cm in breadth, which is inserted
into the lateral lip of the bicipital groove of the humerus.
Ans. A: Lateral lip of bicipital groove of humerus
63. The median nerve controls the coarse movements of the hands, as it supplies most of the long muscles of the front of the
forearm and therefore called the labourers nerve.
The median nerve is formed from parts of the medial and lateral cords of the brachial plexus
The median nerve is the only nerve that passes through the carpal tunnel.
Innervation
Upper Arm
No motor innervation.
Forearm
It innervates most of the flexors in the forearm except flexor carpi ulnaris and the medial two digits of flexor digitorum
profundus, which are supplied by the ulnar nerve.
Unbranched, the median nerve supplies the following muscles:
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor digitorum superficialis muscle.
The anterior interosseus branch supplies the following muscles:
Lateral (radial) half of flexor digitorum profundus muscle
Flexor pollicics longus muscle
Pronator quadratus
Hand.
In the hand, the median nerve supplies motor innervation to the 1st and 2nd lumbricals and the muscles of the thenar
eminence of the hand by a recurrent thenar branch.
The rest of the intrinsic muscles of the hand are supplied by the ulnar nerve.
34
Anatomy
Injury
Injury of this nerve at a level above elbow joint results in loss of pronation and a decrease in flexion of the hand at the
wrist joint.
In the hand, thenar muscle are paralysed and atrophy with in time. Opposition and flexion movements of thumb are
lost, and thumb and index finger are arrested in adduction and hyperextension position. This appearance is referred
as ape hand deformity.
In addition, in palmar side of the hand sensation of lateral part of hand, first three fingers and lateral half of the f o u r t h
finger and in dorsal side sensation of distal S! portion of first three fingers and lateral half of distal S! portionof fourth
finger is lost.
Ans. A: Median nerve
64. Erb-Duchenne Palsy

Upper lesions of the brachial plexus are injuries resulting from excessive displacement of the head to the opposite side and
depression of the shoulder on the same side. This causes excessive traction or even tearing of C5 and C6 roots of the plexus.
It occurs in infants during a difficult delivery or in adults after a blow to or fall on the shoulder.
The suprascapular nerve, the nerve to the subclavius, and the musculocutaneous and axillary nerves all possess nerve
fibers derived from C5 and C6 roots and will therefore be functionless.
The following muscles will consequently be paralyzed: the supraspinatus (abductor of the shoulder) and infraspinatus
(lateral rotator of the shoulder); the subclavius (depresses the clavicle); the biceps brachii (supinator of the forearm, flexor
of the elbow, weak flexor of the shoulder) and the greater part of the brachialis (flexor of the elbow) and the coracobrachialis
(flexes the shoulder); and the deltoid (abductor of the shoulder) and the teres minor (lateral rotator of the shoulder).
Thus, the limb will hang limply by the side, medially rotated by the unopposed sternocostal part of the pectoralis major;
the forearm will be pronated because of loss of the action of the biceps.
The position of the upper limb in this condition has been likened to that of a porter or waiter hinting for a tip.
In addition, there will be a loss of sensation down the lateral side of the arm.
Treatment
The three most common treatments from Erbs Palsy are: Nerve transfers (usually from the opposite leg),
sub scapularis releases and latissimus dorsi tendon transfers.
Ans. A: C5, C6
65. The metacarpophalangeal joints become hyperextended because of the paralysis of the lumbrical and interosseous muscles,
which normally flex these joints.
Because the first and second lumbricals are not paralyzed (they are supplied by the median nerve), the hyperextension of
the metacarpophalangeal joints is most prominent in the fourth and fifth fingers.
The interphalangeal joints are flexed, owing again to the paralysis of the lumbrical and interosseous muscles, which
normally extend these joints through the extensor expansion.
The flexion deformity at the interphalangeal joints of the fourth and fifth fingers is obvious because the first and second
lumbrical muscles of the index and middle fingers are not paralyzed.
In long-standing cases the hand will show hollowing between the metacarpal bones caused by wasting of the dorsal
interosseous muscles
True/complete claw hand involving all the fingers is produced by a combined lesion of ulnar and median nerve
Ans. B: Ulnar nerve injury
66. The clavipectoral fascia is a strong sheet of connective tissue that is attached above to the clavicle.
Below, it splits to enclose the pectoralis minor muscle and then continues downward as the suspensory ligament of the
axilla and joins the fascial floor of the armpit.
The coracoclavicular fascia is pierced by the cephalic vein, thoracoacromial artery and vein, lymphatics pasing from the
breast and pectoral region to the apical group of axillary lymph nodes and lateral pectoral nerve.
Ans. D: Basilic vein
67. Trapezius is supplied by spinal part of cranial nerve XI

Ans. D: Trapezius
Ref.: BDC 4th ed., vol.1, page-52, Clinical Anatomy-Snell, 8th ed., pge-447
35
68. The muscles of hypothenar eminence are:

Opponens digiti minimi
Flexor digiti minimi
Abductor digiti minimi
Palmar brevis
The intrinsic muscles of hand can be remembered using the mnemonic, A OF A OF A (P) for, Abductor pollicis longus,
Opponens pollicis, Flexor pollicis brevis, Adductor pollicis (thenar muslces) and Opponens digiti minimi, Flexor digiti
minimi, Abductor digiti minimi and Palmar brevis (Hypothenar muscles)
They are all supplied by the deep branch of the ulnar nerve.
Ans. A: Ulnar nerve
69. The flexor retinaculum stretches across the front of the wrist and converts the concave anterior surface of the hand into an
osteofascial tunnel, the carpal tunnel, for the passage of:
The median nerve
Flexor tendons of the thumb (flexor pollicis longus and fingers) (flexor digitorum superficialis and profundus).
Radial and the ulnar bursa
It is attached medially to the pisiform bone and the hook of the hamate and laterally to the tubercle of the scaphoid and
the trapezium bones.
The attachment to the trapezium consists of superficial and deep parts and forms a synovial-lined tunnel for passage of
the tendon of the flexor carpi radialis.
The lower border is attached to the palmar aponeurosis.
Ans. B: Median nerve
70. Coracoclavicular ligaments:

Stronger, vertically directed contains conoid and trapezoid ligaments help to control vertical stability
Coracoclavicular ligament are suspensory ligaments of upper limb.
Conoid:
Is the most important ligament for support of the joint against significant injuries and superior displacement;
Cone shaped which extends between the conoid tubercle on the posterior clavicle and the base of the coracoid.
Trapezoid:
Resists AC joint compression;
Begins anteriorly and laterally to the conoid ligament on the clavicle and inserts on the coracoid process.
Ans. B: Coracoclavicular ligament
Ref.: Internet resources
71. Anatomy of radial nerve

Formed by: Axons from
Roots: C5 to T1
Brachial plexus
Trunks: Superior, Medial and Inferior
Cord: Posterior
Axons pass through
Spiral groove of humerus
Fibrous arch attachment of triceps to humerus
Lateral intermuscular septum below deltoid insertion
Arcade of Frohse: Above supinator and below elbow
Branches
Above elbow
Above spiral groove (humerus)
Cutaneous nerves to arm: Posterior; Lower lateral
Cutaneous nerve to forearm: Posterior
Triceps brachii: 3 to 5 branches
Anconeus
Below spiral groove
Brachioradialis: Distal to lateral intermuscular septum
36
Anatomy
Extensor carpi radialis longus and brevis

Supply lateral and dorsolateral arm and forearm
At or below elbow
Above arcade of Frohse (Supinator): Final bifurcation
Superficial radial nerve: Sensory dorsolateral hand and First 3 digits
Posterior interosseus nerve (deep branch): Extensor carpi radialis brevis and supinator
Passes through arcade of Frohse
Arcade of Frohse location: Between 2 heads of supinator muscle
Anatomy of posterior interosseus nerve:
Passes through the supinator muscle
Innervates: All extrinsic wrist extensors except ECRL
Finger and thumb extensors - Most distal radial innervated muscle: extensor indicis proprius
Extensor carpi ulnaris
Abductor pollicis longus
Sensory: Articular branches to wrist joint.
Ans. C : Radial nerve
Ref.: BDC, 4th Ed., vol-I, page-90
72. Clavicle is generally said to have no medullary cavity, but this is not always true
Peculiarities of Clavicle:
It has no medullary cavity
It is the first bone to ossify in the fetus (5th-6th week)
It is the only long bone having 2 primary centers of ossification (others have only 1)
It is the only long bone that ossifies in membrane and not in cartilage
It is the only long bone lying horizontally
It is the most common fractured long bone in the body
It is subcutaneous throughout
Ans. B: Clavicle
Ref.: BDC, 4th ed., Vol.-I, p-7; 5th ed., p-8
73. Vertebral level of the lower angle of scapula is D7

Other interesting facts related to scapula
Winging of scapula: Injury to the thoracic nerve (of Bell). Prominence of medial border of scapula particularly on
pushing against the wall
Fracture of scapula: Rare, may be seen in violent trauma
Sprengels shoulder: Scapula remains elevated, there is failure of descent
Klippel-Feil deformity: Bilateral failure of descent of scapula. Webbing of neck and limitation of neck movements due
to failure of fusion of occipital bone and cervical spine defects is a feature
Ans. B: D7
Ref.: Maheshwaris Orthopaedics, 3rd ed., p-172t; Grays Anatomy, 38th ed., p-1924
THORAX
74. Vertebral levels
5th rib, 5th intercostal space, T9 vertebra: Right and left dome of diaphragm at max expiration
C3 vertebra: Hyoid bone
C6 vertebra: Inferior border of cricoid cartilage, division of larynx and trachea
C6 vertebra: Inferior cricoid cartilage, division of larynx and trachea
C6-T1 vertebra: Thyroid gland
C7 vertebra: Vertebra prominens
C7 vertebra: Superior limit of rhomboid minor
L1 vertebra: Superior mesenteric artery
L1-L2 vertebra: Left crus of diaphragm
L1-L3 vertebra: Right crus of diaphragm
L3 to L4 vertebra: Umbilicus
L3 vertebra: Inferior mesenteric artery and lower border of 10th rib
L3 vertebra: Right kidney present but not left
37
L4 vertebra: Bifurcation of abdominal aorta

L4 vertebra: Tubercle of iliac crest and bifurcation of abdominal aorta
L4 vertebra: Tubercle of iliac crest
L5 vertebra: Convergence of common iliac veins
S2 vertebra: PSIS
S4 vertebra: Natal cleft
T1 vertebra: Sternoclavicular joint
T2 vertebra: Superior angle of the scapula
T3 vertebra: Base of spine of scapula
T4-T5 intervertebral disc: Sternal angle
T4-T5 intervertebral disc: Bifurcation of trachea
T5 vertebra: Inferior border of rhomboid major
T5-T9 vertebra: Sternum proper
T8 vertebra: Caval hiatus of diaphragm
T9 vertebra: Xiphosternal joint
T10 vertebra: Esophogeal hiatus of diaphragm
T12 vertebra: Celiac trunk
T12 vertebra: Superior border of kidneys
T12 vertebra: Aortic hiatus of diaphragm
Ans. C i.e. 2nd lumbar
Ref: BDC-II, 5th ed., p-335
75. Anterior cardiac vein

The anterior cardiac veins (or anterior veins of right ventricle), comprising three or four small vessels which collect
blood from the front of the right ventricle and open into the right atrium.
Unlike most cardiac veins, it does not end in the coronary sinus.
Instead, these veins drain directly into the anterior wall of the right atrium.
Ans. A i.e. Anterior cardiac vein
76. Coronary sinus

It is a collection of veins joined together to form a large vessel that collects blood from the heartmuscle (myocardium).
It delivers deoxygenated blood to the right atrium, as do the superior and inferior vena cava.
The coronary sinus opens into the right atrium, at the coronary sinus orifice, between the inferior vena cava and the
right atrioventricular orifice.
It returns the blood from the substance of the heart, and is protected by a semicircular fold of the lining membrane of
the auricle, the valve of coronary sinus (or valve of Thebesius).
Ans. A i.e. Coronary sinus
77. Sternal angle
It varies around 162 degrees in males
It marks the approximate level of the 2nd pair of costal cartilages, which attach to the second ribs, and the level of the
intervertebral disc between T4 and T5.
The angle also marks a number of other features:
Boundary between the superior and inferior portion of the mediastinum
Passage of the thoracic duct from right to left behind esophagus
Aortic Arch
Tracheal Bifurcation
End of the azygos system into SVC
Ligamentum arteriosum
Loop of left recurrent laryngeal nerve around aortic arch
Aortic arch starts and ends
Ans. B i.e. 2nd rib
38
Anatomy
78. Diaphragm
It is crucial for breathing and respiration.
Its responsible for 45% of the air that enters the lungs during quiet breathing.
During inhalation, the diaphragm contracts, thus enlarging the thoracic cavity (the external intercostal muscles also
participate in this enlargement).
This reduces intra-thoracic pressure: in other words, enlarging the cavity creates suction that draws air into the lungs.
When the diaphragm relaxes, air is exhaled by elastic recoil of the lung and the tissues lining the thoracic cavity in
conjunction with the abdominal muscles which act as an antagonist paired with the diaphragms contraction.
Ans. A i.e. Diaphragm
79. Surface marking of pleura

All the even ribs, in order: 2, 4, 6, 8, 10, 12 show its route:
Rib2: Sharp angle inferiorly
Rib4: The left pleura does a lateral shift to accommodate heart
Rib6: Both diverge laterally
Rib8: Midclavicular line
Rib10: Midaxillary line
Rib12: The back
Ans. C i.e. 10th rib
80. The esophagus is considered to be located in the superior and posterior mediastinum.
Ans. B i.e. Oesophagus
81. Ans. D i.e. T4

82. The spaces between the ribs contain three muscles of respiration: the external intercostal, the internal intercostal, and
the transversus thoracis muscle.
The intercostal nerves and blood vessels run between the intermediate and deepest layers of muscles. They are
arranged in the following order from above downward: intercostal vein, intercostal artery, and intercostal nerve
(i.e., VAN).
Ans. A: VAN
83. Inhalation of foreign bodies into the lower respiratory tract is common, especially in children.
Parts of teeth may be inhaled while a patient is under anesthesia during a difficult dental extraction.
Because the right bronchus is the shorter (2.5 cm), wider and more direct continuation of the trachea, foreign bodies
tend to enter the right instead of the left bronchus. From there, they usually pass into the middle or lower lobe bronchi.
Ans. B: Lower lobe of right lung
84. The visceral layer is closely applied to the heart and is often called the epicardium.
The slitlike space between the parietal and visceral layers is referred to as the pericardial cavity.
Normally, the cavity contains a small amount of tissue fluid (about 50 mL), the pericardial fluid, which acts as a lubricant
to facilitate movements of the heart.
Ans. A: 50 ml
85. The arch of the aorta is a continuation of the ascending aorta.

It lies behind the manubrium sterni and arches upward, backward, and to the left in front of the trachea (its main direction
is backward).
It then passes downward to the left of the trachea and, at the level of the sternal angle, becomes continuous with the
descending aorta.
39
Branches
The brachiocephalic artery divides into the right subclavian and right common carotid arteries behind the right
sternoclavicular joint.
The left common carotid artery runs upward and to the left of the trachea and enters the neck behind the left
sternoclavicular joint.
The left subclavian artery runs upward along the left side of the trachea and the esophagus to enter the root of the
neck. It arches over the apex of the left lung.
Ans. C: Brachiocephalic artery
86. The trachea begins in the neck as a continuation of the larynx at the lower border of the cricoid cartilage at the level of
the sixth cervical vertebra.
In the cadaver, trachea ends below at the carina by dividing into right and left principal (main) bronchi at the level of
the sternal angle (opposite the disc between the fourth and fifth thoracic vertebrae).
In living subjects, in the erect posture, the bifurcation lies at the lower border of the sixth thoracic vertebra.
In adults the trachea is about 10-15 cm long and 2 cm in diameter.
The fibroelastic tube is kept patent by the presence of U-shaped bars (rings) of hyaline cartilage embedded in its wall.
The posterior free ends of the cartilage are connected by smooth muscle, the trachealis muscle.
Ans. C: Opposite the disc between the T4-T5 vertebrae
87. The left coronary artery, which is usually larger than the right coronary artery, supplies the major part of the heart,
including the greater part of the left atrium, left ventricle, and ventricular septum.
It arises from the left posterior aortic sinus of the ascending aorta.
It then enters the atrioventricular groove and divides into an anterior interventricular branch and a circumflex branch.
Branches
The anterior interventricular (descending) branch /left anterior descending (LAD) runs downward in the anterior
interventricular groove to the apex of the heart.
The anterior interventricular branch supplies the right and left ventricles with numerous branches that also supply the
anterior part of the ventricular septum. One of these ventricular branches (left diagonal artery) may arise directly from the
trunk of the left coronary artery.
The left circumflex artery (LCX) is the same size as the anterior interventricular artery. It winds around the left margin
of the heart in the atrioventricular groove. A left marginal artery is a large branch that supplies the left margin of the
left ventricle down to the apex. Anterior ventricular and posterior ventricular branches supply the left ventricle. Atrial
branches supply the left atrium.
Posterior interventricular branch: It is typically a branch of the right coronary artery (80%, known as right dominance).
Alternately, the Posterior interventricular branch can be a branch of the left circumflex coronary artery (20%, known as left
dominance) which itself is a branch of the left coronary artery
Ans. D: Posterior interventricular branch
88. The arch of the aorta is a continuation of the ascending aorta.

It lies behind the manubrium sterni and arches upward, backward, and to the left in front of the trachea (its main
direction is backward).
It then passes downward to the left of the trachea and, at the level of the sternal angle, becomes continuous with the
descending aorta.
Branches
The brachiocephalic artery arises from the convex surface of the aortic arch.
It passes upward and to the right of the trachea and divides into the right subclavian and right common
carotid arteries behind the right sternoclavicular joint.
The left common carotid artery arises from the convex surface of the aortic arch on the left side of the brachiocephalic artery.
It runs upward and to the left of the trachea and enters the neck behind the left sternoclavicular joint.
The left subclavian artery arises from the aortic arch behind the left common carotid artery.
It runs upward along the left side of the trachea and the esophagus to enter the root of the neck.
It arches over the apex of the left lung.
Ans. B: Right common carotid artery arises from the arch of aorta
40
Anatomy
89. Aortic opening lies at the level of T12 vertebrae. It transmits:

Aorta
Thoracic duct
Azygous vein
Ans. D: Hemiazygous vein
90. Ans. B: Left dominance

91. The esophagus has four constrictions.

Where the pharynx joins the upper end - 15 cm from incisor teeth
The second is at the where the aortic arch - 22.5 cm from incisor teeth
The left bronchus cross its anterior surface - 27.5 cm from incisor teeth
Where the esophagus passes through the diaphragm into the stomach - 37.5 cm from incisor teeth
These constrictions are of considerable clinical importance because they are sites where swallowed foreign bodies can
lodge or through which it may be difficult to pass an esophagoscope.
Because a slight delay in the passage of food or fluid occurs at these levels, strictures develop here after the drinking of
caustic fluids. Those constrictions are also the common sites of carcinoma of the esophagus.
Ans. D: At the point of crossing of thoracic duct
92. Bochdalek hernia (involves an opening on the left side of the diaphragm) occur posteriorly and are due to a defect in the
posterior attachment of the diaphragm when there is a failure of pleuroperitoneal membrane closure in utero.
Retroperitoneal structures may prolapse through the defect, e.g. retroperitoneal fat, spleen or left kidney.
Bochdalek hernias occur more commonly on the posterior left side (85%, versus right side 15%).
Complications are usually due to pulmonary hypoplasia.
In adults, incidentally-discovered posterior diaphragmatic hernias are rare. Of these, right-sided hernias are more common
(68%), and more frequently in females.
The great majority are small, with only 27% containing abdominal organs such as bowel, spleen or liver.
Morgagni hernia A Morgagni hernia involves an opening on the right side of the diaphragm. The liver and intestines
usually move up into the chest cavity.
Ans. B: Posterior and left
93. Coronary sinus receives blood mainly from the small, middle, great and oblique cardiac veins.
It also receives blood from the right marginal vein and the left posterior ventricular vein.
Most blood from the heart wall drains into the right atrium through the coronary sinus, which lies in the posterior part of
the atrioventricular.
It opens into the right atrium to the left of the inferior vena cava.
The anterior cardiac veins drain directly into the right atrium
Ans. A: Anterior cardiac vein
94. Thoracic Part of the Sympathetic Trunk is continuous above with the cervical and below with the lumbar parts of the
sympathetic trunk.
It is the most laterally placed structure in the mediastinum and runs downward on the heads of the ribs.
It leaves the thorax on the side of the body of the 12th thoracic vertebra by passing behind the medial arcuate ligament.
The sympathetic trunk has 12 (often only 11) segmentally arranged ganglia, each with white and gray ramus communicans
passing to the corresponding spinal nerve.
The first ganglion is often fused with the inferior cervical ganglion to form the stellate ganglion.
Branches
The postganglionic fibers are distributed through the branches of the spinal nerves to the blood vessels, sweat glands,
and erector pili muscles of the skin.
The first five ganglia give postganglionic fibers to the heart, aorta, lungs, and esophagus.
The lower eight ganglia mainly give preganglionic fibers, which are grouped together to form the splanchnic nerves
and supply the abdominal viscera.
Ans. D: The first ganglion is often fused with the inferior cervical ganglion to form the stellate ganglion
Ref.: BDC 4th ed., vol.1, page-215, Clinical Anatomy-Snell, 8th ed., page-128 41
95. The esophagus is a muscular, collapsible tube about 10 in. (25 cm) long that joins the pharynx to the stomach.
The esophagus enters the abdomen through an opening in the right crus of the diaphragm.
After a course of about 0.5 in. (1.25 cm), it enters the stomach on its right side.
Ans. A: 25 cm
96. The heart has three surfaces: sternocostal (anterior), diaphragmatic (inferior), and a base (posterior).
It also has an apex, which is directed downward, forward, and to the left.
The sternocostal surface is formed mainly by the right atrium and the right ventricle.
The right border is formed by the right atrium; the left border, by the left ventricle and part of the left auricle.
The diaphragmatic surface of the heart is formed mainly by the right and left ventricles. The inferior surface of the right
atrium, into which the inferior vena cava opens, also forms part of this surface.
The base of the heart, or the posterior surface, is formed mainly by the left atrium, into which open the four pulmonary
veins.
Ans. B: Left atrium
97. The lower border of the lung in midinspiration follows a curving line, which crosses the 6th rib in the midclavicular
line and the 8th rib in the midaxillary line, and reaches the 10th rib adjacent to the vertebral column posteriorly.
Ans. B: 6th rib
98. Trachea is kept patent by the presence of U-shaped bars (rings) of hyaline cartilage embedded in its wall.
The posterior free ends of the cartilage are connected by smooth muscle, the trachealis muscle.
Ans. C: C shaped
99. The right coronary artery arises from the anterior aortic sinus of the ascending aorta and runs forward between the
pulmonary trunk and the right auricle.
The artery of the sinuatrial node (branch of right coronary artery) supplies the SA node and the right and left atria; in 40%
of individuals it arises from the left coronary artery.
Ans. D: Right coronary artery
100. Apart from the diaphragm and the intercostals, other less important muscles also contract on inspiration and assist in
elevating the ribs, namely, the levatores costarum muscles and the serratus posterior superior muscles.
Quiet expiration occurs passively by the elastic recoil of the pulmonary alveoli and thoracic wall.
In deep forced inspiration, a maximum increase in the capacity of the thoracic cavity occurs. Every muscle that can raise
the ribs is brought into action, including the scalenus anterior and medius and the sternocleidomastoid.
In respiratory distress the action of all the muscles already engaged becomes more violent, and the scapulae are fixed by the
trapezius, levator scapulae, and rhomboid muscles, enabling the serratus anterior and pectoralis minor to pull up the ribs.
Forced expirartion is brought about by the muscles of the abdominal wall and the latissimus dorsi
Ans. D: None of the above
101. The origin of the azygos vein is variable. It is often formed by the union of the right ascending lumbar vein and the right
subcostal vein.
It ascends through the aortic opening in the diaphragm on the right side of the aorta to the level of the fifth thoracic
vertebra.
Here it arches forward above the root of the right lung to empty into the posterior surface of the superior vena cava.
The azygos vein has numerous tributaries, including the fifth to eleventh right posterior intercostal veins, the right
superior intercostal vein, the hemiazygos and the accessory hemiazygos veins, and numerous esophagral, mediastinal and
pericardial veins.
Ans. B: Superior vena cava
42
Anatomy
102. In 85% of patients the right coronary artery (RCA) is said to be dominant because it supplies circulation to the inferior
portion of the interventricular septum via the right posterior descending coronary artery/posterior interventricular
artery.
In these cases the RCA travels to the cross-section of the AV groove and the posterior interventricular (IV groove). Here,
it gives rise to the right posterior descending coronary artery (PDA) branch which travels in the posterior IV groove and
gives off several septal perforator branches (SP). The SP supply blood to the lower portion of the IV septum.
Generally, the dominant RCA also gives rise to the AV nodal branch which supplies blood to the AV node
The dominant RCA also provides the right postero-lateral (PLA) branch to the lower postero-lateral portion of the left
ventricle.
The sinus or sino-atrial (SA) node branch originates in the proximal portion of the RCA in 60% of cases and as a left atrial
branch of the Cx in the remaining 40% of cases. This is unrelated to whether the artery is dominant or not.
Ans. B: Supplying circulation to the inferior portion of the interventricular septum
103. If the superior or inferior vena cava is obstructed, the venous blood causes distention of the veins running from the anterior
chest wall to the thigh.
The lateral thoracic vein anastomoses with the superficial epigastric vein, a tributary of the great saphenous vein of the leg.
In these circumstances, a tortuous varicose vein may extend from the axilla to the lower abdomen
The most common cause of superior vena cava syndrome is cancer.
Primary or metastatic cancer in the upper lobe of the right lung can compress the superior vena cava.
Lymphoma or other tumors located in the mediastinum can also cause compression of the superior vena cava.
Less often, the superior vena cava can become blocked with a blood clot from within.
Invasive medical procedures (Blood clot (thrombus) formation that causes superior vena cava syndrome is a
complication of pacemaker wires, dialysis, and other intravenous catheters that are threaded into the superior vena
cava)
Infection (syphilis and tuberculosis) is another cause of superior vena cava syndrome. Sarcoidosis (a disease that
results in masses of inflamed tissue) may also cause this syndrome.
Ans. C: Lung cancer
104. The arch of the aorta (Transverse Aorta) begins at the level of the upper border of the second sternocostal articulation of
the right side, and runs at first upward, backward, and to the left in front of the trachea; it is then directed backward on
the left side of the trachea and finally passes downward on the left side of the body of the fourth thoracic vertebra, at the
lower border of which it becomes continuous with the descending aorta.
Ans. C: T4
Ref.: BDCs Anatomy, Vol-I, 4th ed.,p-260
105. Right border of the mediastinal shadow (chiefly produced due to the heart and the vessels entering and leaving it) is formed from above
downwards by the right brachiocephalic vein, superior vena cava, right atrium and the inferior vena cava
The Base of the Heart
The base is located posteriorly and is formed mainly by the left atrium.
It lies opposite T5 to T8 (supine position) and T6 to T9 vertebrae (erect position) and faces superiorly, posteriorly and
towards the right shoulder.
The base or posterior aspect of the heart is quadrilateral in shape and it is from its most superior part from which the
ascending aorta and pulmonary trunk emerge, and into which the superior vena cava enters.
The base is separated from the diaphragmatic surface of the heart by the posterior part of the coronary groove (L.
sulcus).
The heart does not rest on its base. The term refers to the somewhat conical shape of the heart with the base being
opposite the apex.
The Apex of the Heart
This blunt apex is formed from by the left ventricle, which points inferolaterally.
The apex is located posterior to the left 5th intercostal space in adults, 7 to 9 cm from the median plane, and just left of
the midclavicular line.
The apex beat is an impulse imparted by the hear; it is its point of maximal pulsation or the lowest, most lateral point
at which pulsation can be felt.
43
The Sternocostal (Anterior) Surface of the Heart

This surface of the heart is mainly formed by the right ventricle and is visible in PA radiographs of the thorax.
The Diaphragmatic (Inferior) Surface of the Heart
The surface of the heart is usually horizontal or slightly concave.
It is formed by both ventricles, mainly the left one.
The posterior interventricular sulcus divides this surface into a right 1/3 and a left 2/3.
The Pulmonary (Left) Surface of the Heart
This surface of the heart is mainly formed by the left ventricle and occupies the cardiac notch of the left lung.
The Borders of the Heart
The heart has four borders: right, inferior, left, and superior.
These borders are actually the borders of its sternocostal surface.
The right border is formed by the right atrium.It is slightly convex and is almost in line with the superior and inferior
vena cavae.
The inferior border is sharp and thin, and nearly horizontal. It is formed mainly by the right ventricle and only slightly
by the left ventricle.
The left border is formed mainly by the left ventricle and only slightly by the left auricle.
The superior border is where the great vessels enter and leave the heart. It is formed by the right and left auricles and
the superior conical portion of the right ventricle, the conus arteriosus (infundibulum), between them.
The pulmonary trunk arises from the conus arteriosus.
Radiological Anatomy of the Heart
In PA radiographs of the thorax, the right border of the cardiovascular silhouette is formed by (superior to inferior):
(1) the superior vena cava; (2) the right atrium; (3) the inferior vena cava.
The left border of the cardiovascular silhouette is formed by: (1) the arch of the aorta, which produces a characteristic
aortic knob; (2) the pulmonary trunk; (3) the left auricle; (4) the left ventricle.
Ans. B: Arch of aorta
106. Venacaval opening lies in the central tendon of the diaphragm at the level of T8 and it transmits inferior vena cava and branches of right
phrenic nerve
Diaphragm
T8 Level: Caval hiatus (through central tendon of the diaphragm) transmitting the inferior vena cava, branches of
right phrenic nerve
T9 Level: Foramen of Morgagni also called sternocostal hiatus two on each side of the xiphoid process. Transmitting
the superior epigastric vessels.
T10 Level: Esophageal hiatus (through muscular part) transmitting the esophagus, gastric (vagus) nerve and
esophageal branches of the left gastric artery and accompanying veins
T12 Level: Aortic hiatus (osseoaponeurotic) transmitting the aorta, the azygous vein, and the thoracic duct.
A commonly used mnemonic to remember the level of the diaphragmatic apertures is this: Mnemonic
Aortic hiatus = 12 letters = T12
Oesophagus = 10 letters = T10
Vena cava = 8 letters = T8
Embryology:
The central tendinous portions are derived from the pleuroperitoneal folds and the septum transversum.
While the crura are derived from the dorsal esophageal mesentry, the peripheral muscular portions of the diaphragm
are derived from the body wall.
Ans. B: Right Phrenic nerve
Ref.: BDC, 4th ed., Vol.-II, p-185; 5th ed., p-188,189
107. The azygos vein ends by joining the posterior aspect of the superior vena cava
The Azygos Vein
The azygos vein connects the superior and inferior venae cavae, either directly by joining the IVC or indirectly by the
hemiazygos and accessory hemiazygos veins.
The azygos vein drains blood from the posterior walls of the thorax and abdomen.
It ascends in the posterior mediastinum, passing close to the right sides of the bodies of the inferior eight thoracic
vertebrae (T4-T12).
44
Anatomy
I t is covered anteriorly by the oesophagus as it passes posterior to the root of the right lung.
It then arches over the superior aspect of this root to join the SVC.
In addition to the posterior intercostal veins, the azygos vein communicates with the vertebral venous plexuses.
This vein also receives the mediastinal, oesophageal, and bronchial veins.
Ans. C: Superior vena cava
Ref.: BDC/I, 5th ed., p-218
INFERIOR EXTREMITY
108. Ans. A i.e. Anterosuperior

109. Innervation of adductor magnus

Posterior division of obturator nerve innervates most of the adductor magnus
Vertical or hamstring portion innervated by tibial nerve (L2, L3, L4)
Ans. C i.e. Both
Ref: BDC-II, 5th ed., p-93t
110. Branches of femoral nerve

Anterior division: In the thigh the anterior division of the femoral nerve gives off anterior cutaneous and muscular
branches.
Anterior cutaneous branches: The anterior cutaneous branches comprise the following nerves:
Intermediate femoral cutaneous nerve and
Medial femoral cutaneous nerve (Note the lateral femoral cutaneous nerve is a branch from the lumbar
plexus.)
Muscular branches (rami musculares):
The nerve to the Pectineus arises immediately below the inguinal ligament.
The nerve to the Sartorius arises in common with the intermediate cutaneous.
Posterior division: The posterior division- muscular branches supply the four parts of the Quadriceps femoris.
The branch to the Rectus femoris enters the upper part of the deep surface of the muscle, and supplies a filament
to the hip-joint.
The branch to the Vastus lateralis, of large size, accompanies the descending branch of the lateral femoral
circumflex artery.
The branch to the Vastus medialis descends lateral to the femoral vessels in company with the saphenous nerve.
The branches to the Vastus intermedius.
The articular branch to the hip-joint is derived from the nerve to the Rectus femoris.
The articular branches to the knee-joint are three in number.
One, a long slender filament, is derived from the nerve to the Vastus lateralis.
Another, derived from the nerve to the Vastus medialis
The third branch is derived from the nerve to the Vastus intermedius.
Ans. D i.e. Femoral nerve
111. Ans. C i.e. Lacunar ligament

112. Proximal surface of cuboid articulates with calcaneum, distal surface with 4th and 5th metatarsal and medial surface articulates with
lateral cuneiform bone.
Ans. D i.e. Cuboid
Ref: BDC-II, 5th ed., p-33, 37
113. The talocalcaneonavicular and the calcaneocuboid joints are together referred to as the midtarsal or transverse tarsal joints.
The important movements of inversion and eversion of the foot take place at the subtalar and transverse tarsal joints.
Inversion is the movement of the foot so that the sole faces medially.
Eversion is the opposite movement of the foot so that the sole faces in the lateral direction.
Inversion is performed by the tibialis anterior, the extensor hallucis longus, and the medial tendons of extensor digitorum
longus; the tibialis posterior also assists.
45
Eversion is performed by the peroneus longus, peroneus brevis, and peroneus tertius; the lateral tendons of the extensor
digitorum longus also assist.
Ankle joints active movements are dorsiflexion and plantar flexion
Inferior Tibiofibular joint permits slight movements so that the lateral malleolus can rotate laterally during dorsiflexion
of the ankle
Ans. A: Subtalor joints
Ref.: BDC 4th ed., vol.2, page-154,153,152, Clinical Anatomy-Snell, 8th ed., page-638
114. In patients with occlusive coronary disease caused by atherosclerosis, the diseased arterial segment can be bypassed by
inserting a graft consisting of a portion of the great saphenous vein.
The venous segment is reversed so that its valves do not obstruct the arterial flow. Following removal of the great
saphenous vein at the donor site, the superficial venous blood ascends the lower limb by passing through perforating
veins and entering the deep veins.
The great saphenous vein can also be used to bypass obstructions of the brachial or femoral arteries.
Ans. A: Great saphenous vein
115. Other attachments on the ischial tuberosity are:

Long head of biceps femoris
Sacrotuberous ligament
Ischiofemoral ligament
Adductor longus arises from the body of pubis
Ans. A: Adductor longus
Ref.: BDC 4th ed., vol.2, page-13,11
116. Deep Fascia of the Thighs (Fascia Lata) upper end is attached to the pelvis and the inguinal ligament.
On its lateral aspect, it is thickened to form the iliotibial tract, which is attached above to the iliac tubercle and below to
the lateral condyle of the tibia. The iliotibial tract receives the insertion of the tensor fasciae latae and the greater part of the
gluteus maximus muscle.
In the gluteal region, the deep fascia forms sheaths, which enclose the tensor fasciae latae and the gluteus maximus
muscles.
The saphenous opening is a gap in the deep fascia in the front of the thigh just below the inguinal ligament. It transmits the
great saphenous vein, some small branches of the femoral artery, and lymph vessels.
The saphenous opening is filled with loose connective tissue called the cribriform fascia.
Ans. C: Medially the fascia is thickened to form iliotibial tract
117. Abdominal herniae are of the following common types:

Inguinal (indirect or direct)
Femoral
Umbilical (congenital or acquired)
Epigastric
Separation of the recti abdominis
Incisional
Hernia of the linea semilunaris (Spigelian hernia)
Lumbar (Petits triangle hernia)
Hernial sac in indirect inguinal hernia may extend through the superficial inguinal ring above and medial to the pubic
tubercle whereas in femoral hernias the sac is located below and lateral to the pubic tubercle
The indirect inguinal hernia can be summarized as follows:
It is the remains of the processus vaginalis and therefore is congenital in origin.
It is more common than a direct inguinal hernia.
It is much more common in males than females.
It is more common on the right side.
It is most common in children and young adults.
The hernial sac enters the inguinal canal through the deep inguinal ring and lateral to the inferior epigastric vessels. The
neck of the sac is narrow.
The hernial sac may extend down into the scrotum or labium majus.
46
Anatomy
A direct inguinal hernia can be summarized as follows:

It is common in old men with weak abdominal muscles and is rare in women.
The hernial sac bulges forward through the posterior wall of the inguinal canal medial to the inferior epigastric vessels.
The neck of the hernial sac is wide.
Ans. B: Below and lateral
118. Pulsations of the femoral artery can be felt at the midinguinal point against the head of the femur
Femoral artery
It begins immediately behind the inguinal ligament, midway between the anterior superior spine of the ilium and the
symphysis pubis, and passes down the front and medial side of the thigh (hence palpated in this region).
It ends at the junction of the middle with the lower third of the thigh, where it passes through an opening in the
Adductor magnus to become the popliteal artery.
The vessel, at the upper part of the thigh, lies in front of the hip-joint; in the lower part of its course it lies to the medial
side of the body of the femur, and between these two parts, where it crosses the angle between the head and body, the
vessel is some distance from the bone.
The first 4 cm. of the vessel is enclosed, together with the femoral vein, in a fibrous sheaththe femoral sheath.
In the upper third of the thigh the femoral artery is contained in the femoral triangle (Scarpas triangle), and in the
middle third of the thigh, in the adductor canal (Hunters canal).
Ans. D: Mid-inguinal point
Ref.: BDC, 3rd ed., Vol.-II, p-48; 5th ed, p-61
119. Prepatellars bursitis is called housemaids knee or miners knee

Ans. C: Prepatellar bursa
Ref.: BDC, 4th ed., Vol.-II, p-48; 5th ed, p-63
120. Prepatellars bursitis is called housemaids knee or miners knee

Prepatellar bursitis
It is a common cause of swelling and pain above the patella
It is due to inflammation of the prepatellar bursa.
This structure is a superficial bursa with a thin synovial lining located between the skin and the patella.
The bursa develops within the first years of life as a result of mechanical pressure and friction, and it serves the
purpose of reducing friction on underlying structures and allowing maximal range of motion in the knee.
Aseptic prepatellar bursitis is commonly caused by repetitive work in a kneeling position, hence the name housemaids
knee.
Infrapatellar bursitis/clergymans knee
It is the inflammation of the infrapatellar bursa, which is located just below the patella.
It is often called clergymans knee due to its historical frequency amongst clergyman, who injured the bursa by kneeling
on hard surfaces during prayer.
Ans. B: Prepatellar bursa
Ref.: BDC, 4th ed., Vol-II, p-48
ABDOMEN
121. Ans. D i.e. Sacral region

122. Ans. C i.e. 25 cm

123. Ans. C i.e. Inferior mesenteric artery

Ref: Langmans Embryology, 11th ed., p-242
124. Ans. C i.e. D12-L3

47
125. Ans. C i.e. Inferior phrenic artery

126. Ans. B i.e. Dorsal mesogastrium

127. Ans. B i.e. D10

128. Ans. D i.e. Mesentery

129. Ans. C i.e. Inferior rectal artery

Ref: BDC-II, 5th ed., p-450t
130. Ans. B i.e. Base

131. Ans. C i.e. Ileocolic artery

132. Ans. C i.e. Descending colon

133. Ans. A i.e. 1.5 metres

134. Arteries and their origin

The uterine artery is a branch of the anterior division of the internal iliac artery
External and internal iliac arteries are terminal branches of abdominal aorta
Gonadal arteries (ovarian and testicular) arise from the front of the aorta a little below the origin of renal arteries
Ans: A i.e. Anterior internal iliac artery
Ref: BDC, 3rd ed., Vol: II, p-319
135. The visceral surface of the spleen is related to the fundus of the stomach, the anterior surface of the left kidney, the splenic
flexure of the colon and the tail of the pancreas
Ans: B i.e. Duodenum
Ref: BDC, 3rd ed., Vol: II, p-245
136. Spermatic fascia

It is a bilayered fascia covering the testis; both layers are derived from abdominal muscle or fascia.
The more superficial of these two layers,
The external spermatic fascia, lies deep to the skin and dartos fascia of the testes, superficial to the cremaster
muscle, and is a continuation of the aponeurosis of the external oblique muscle.
The deeper internal spermatic fascia is deep to the cremaster muscle, directly surrounds the spermatic cord and
its contents, and is a continuation of the abdominal transversalis fascia.
Ans. C i.e. Fascia transversalis
137. Ilioinguinal nerve

It is a branch of the first lumbar nerve (L1).
It separates from the first lumbar nerve along with the larger iliohypogastric nerve.
It emerges from the lateral border of the psoas major just inferior to the iliohypogastric, and passes obliquely across
the quadratus lumborum and iliacus.
The ilioinguinal nerve then perforates the transversus abdominis near the anterior part of the iliac crest, and
communicates with the iliohypogastric nerve between the transversus and the obliquus internus.
It then pierces the obliquus internus, distributing filaments to it, and then accompanies the spermatic cord through
the superficial inguinal ring.
Ans. C i.e. Ilio-inguinal nerve
48
Anatomy
138. Lesser sciatic notch

It lies below the ischial spine
It is smooth, coated in the recent state with cartilage, the surface of which presents two or three ridges corresponding
to the subdivisions of the tendon of the Obturator internus, which winds over it.
It is converted into a foramen, the lesser sciatic foramen, by the sacrotuberous and sacrospinous ligaments, and
transmits the tendon of the Obturator internus, the nerve which supplies that muscle, and the internal pudendal
vessels and nerve.
Ans. A i.e. Tendon of obturator internus
139. Levator ani with the anal fascia forms the media wall of ischioanal fossa (in the upper part)
Ans. A i.e. Levator ani
140. The lateral part of the broad ligament of uterus, extending from the infundibulum of the uterine tube and the upper pole of
the ovary, to the external iliac vessels, forms a distinct fold known as suspensory ligament of the ovary or infundibulopelvic
ligament.
Ans. A i.e. Infundibulopelvic ligament
Ref: BDC-II, 4th ed., p-354, 361
141. Ovarian vein/ Female gonadal vein

It carries deoxygenated blood from its corresponding ovary to inferior vena cava or one of its tributaries
It is the female equivalent of the testicular vein, and is the venous counterpart of the ovarian artery.
It can be found in the suspensory ligament of the ovary
It is a paired vein, each one supplying an ovary.
The right ovarian vein travels through the suspensatory ligament of the ovary and generally joins the inferior
vena cava.
The left ovarian vein, unlike the right, often joins the left renal vein instead of the inferior vena cava.
Ans. B i.e. Left renal vein
142. Ureters is slightly constricted at 5 places. One site is at the point of crossing of ureter by ductus deferens or broad
ligament of uterus.
Ans. C i.e. At the crossing by external iliac artery
143. The vagina has no glands, and therefore must rely on other methods of lubrication. Plasma seepage from vaginal walls due
to vascular engorgement is considered to be the chief lubrication source, and the Bartholins glands, located slightly below
and to the left and right of the introitus (opening of the vagina), also secrete mucus to augment vaginal-wall secretions.
Ans. C i.e. Lacks mucus secreting glands
Ref: BDC-II, 4th ed., p-364-365
144. Small intestine dimensions

The average length of the small intestine in an adult human male is 6.9 m (22 feet 6 inches), and in the adult female 7.1
m (23 feet 4 inches).
It can vary greatly, from as short as 4.6 m (15 feet) to as long as 9.8 m (32 feet).
It is approximately 2.53 cm in diameter.
Ans. B i.e. 6 metres
145. Female urethra

It is about 1.5 inches (3.8 cm) to 2 inches (5.1 cm) long and exits the body between the clitoris and the vagina, extending
from the internal to the external urethral orifice.
Its diameter when undilated is about 6 mm.
Ans. D i.e. 6 mm
49
146. The branches of these divisions supply the pelvic viscera, the perineum, the pelvic walls, and the buttocks.
Branches of the Anterior Division:
Umbilical artery: From the proximal patent part of the umbilical artery arises the superior vesical artery, which
supplies the upper portion of the bladder.
Uterine artery: It ends by following the uterine tube laterally, where it anastomoses with the ovarian artery.
Vaginal artery: This artery usually takes the place of the inferior vesical artery present in the male. It supplies the
vagina and the base of the bladder.
Obturator artery: This artery leaves the pelvis through the obturator canal.
Middle rectal artery: Commonly, this artery arises with the inferior vesical artery.
Internal pudendal artery: This artery leaves the pelvis through the greater sciatic foramen and enters the gluteal region
below the piriformis muscle.
Inferior gluteal artery: This artery leaves the pelvis through the greater sciatic foramen below the piriformis muscle.
Inferior vesical artery: This artery supplies the base of the bladder and the prostate and seminal vesicles in the male; it
also gives off the artery to the vas deferens.
Branches of the Posterior Division
Iliolumbar artery
Lateral sacral arteries
Superior gluteal artery: This artery leaves the pelvis through the greater sciatic foramen above the piriformis muscle.
It supplies the gluteal region.
Ovarian artery arises from the abdominal aorta below the renal artery.
Ans. A: Ovarian artery
147. The uterus is supported mainly by the tone of the levator ani muscles and the condensations of pelvic fascia, which
form three important ligaments.
The Levator Ani Muscles and the Perineal Body:
They form a broad muscular sheet. They effectively support the pelvic viscera. The medial edges of the anterior parts
of the levator ani muscles are attached to the cervix of the uterus by the pelvic fascia.
Some of the fibers of levator ani are inserted into a fibromuscular structure called the perineal body. This structure is
important in maintaining the integrity of the pelvic floor; if the perineal body is damaged during childbirth, prolapse
of the pelvic viscera may occur.
Transverse Cervical (Cardinal) Ligaments:
Transverse cervical ligaments are fibromuscular condensations of pelvic fascia that pass to the cervix and the upper
end of the vagina from the lateral walls of the pelvis.
Pubocervical Ligaments:
The pubocervical ligaments consist of two firm bands of connective tissue that pass to the cervix from the posterior
surface of the pubis. They are positioned on either side of the neck of the bladder, to which they give some support
(pubovesical ligaments).
Sacrocervical Ligaments:
The sacrocervical ligaments consist of two firm fibromuscular bands of pelvic fascia that pass to the cervix and the
upper end of the vagina from the lower end of the sacrum. They form two ridges, one on either side of the rectouterine
pouch (pouch of Douglas).
The broad ligaments and the round ligaments of the uterus are lax structures, and the uterus can be pulled up or
pushed down for a considerable distance before they become taut. Clinically, they are considered to play a minor role
in supporting the uterus.
The round ligament of the uterus, which represents the remains of the lower half of the gubernaculum, helps keep
the uterus anteverted (tilted forward) and anteflexed (bent forward) but is considerably stretched during pregnancy.
Ans. C: Broad ligament
148. Superficial Inguinal Lymph Nodes

The horizontal group
The medial members of the group receive superficial lymph vessels from the anterior abdominal wall below the level
of the umbilicus and from the perineum. The lymph vessels from the urethra, the external genitalia of both sexes (but
50 not the testes), and the lower half of the anal canal are drained by this route.
Anatomy
The lateral members of the group receive superficial lymph vessels from the back below the level of the iliac crests.
The vertical group lies along the terminal part of the great saphenous vein and receives most of the superficial lymph
vessels of the lower limb.
The efferent lymph vessels from the superficial inguinal nodes pass through the saphenous opening in the deep fascia and
join the deep inguinal nodes.
Deep Inguinal Lymph Nodes
The deep nodes are located beneath the deep fascia and lie along the medial side of the femoral vein; the efferent vessels
from these nodes enter the abdomen by passing through the femoral canal to lymph nodes along the external iliac artery
Lymphatic Drainage of the Penis
From most of the penis, lymph drains into the superficial inguinal lymph nodes.
Vessels from the glans penis drain into the deep inguinal lymph nodes.
Ans. C: Glans penis
149. Ans. A: Renal fascia

Ref.: BDC 4th ed., vol.2, page-297, Dorlands med dictionary 28th ed. p-609
150. The inguinal canal is an oblique passage through the lower part of the anterior abdominal wall.
The canal is about 1.5 in. (4 cm) long in the adult and extends from the deep inguinal ring, a hole in the fascia transversalis,
downward and medially to the superficial inguinal ring, a hole in the aponeurosis of the external oblique muscle.
In the males, it allows structures to pass to and from the testis to the abdomen.
In females it allows the round ligament of the uterus to pass from the uterus to the labium majus.
Ans. B: External oblique aponeurosis
151. Rectouterine pouch (pouch of Douglas) is the most dependent part of the entire peritoneal cavity (when the patient is
in the standing position), hence it frequently becomes the site for the accumulation of blood (from a ruptured ectopic
pregnancy) or pus (from a ruptured pelvic appendicitis or in gonococcal peritonitis).
Because the pouch lies directly behind the posterior fornix of the vagina, it is commonly violated by misguided
nonsterile instruments, which pierce the wall of the posterior fornix in a failed attempt at an illegal abortion.
A needle may be passed into the pouch through the posterior fornix in the procedure known as culdocentesis.
Surgically, the pouch may be entered in posterior colpotomy. The interior of the female pelvic peritoneal cavity may
be viewed for evidence of disease through an endoscope.
Ans. D: Rectum and Uterus
152. An extensive venous plexus, the pampiniform plexus, leaves the posterior border of the testis.
As the plexus ascends, it becomes reduced in size so that at about the level of the deep inguinal ring, a single testicular
vein is formed.
This runs up on the posterior abdominal wall and drains into the left renal vein on the left side and into the inferior
vena cava on the right side.
Ans. B: Left renal vein
153. The superior mesenteric artery (SMA) arises from the anterior surface of abdominal aorta, just inferior to the origin of the
celiac trunk, and supplies the intestine from the lower part of the duodenum to the left colic flexure and the pancreas.
Branches of SMA
Intestinal arteries (arcadesvasa rectastraight arteries) gives branches to ileum, branches to jejunum-(terminal
branch of the SMA) supplies last part of ileum, cecum, and appendix
Ileocolic artery
appendicular artery
Right Colic artery supplies ascending colon.
Middle Colic artery supplies the transverse colon.
Inferior pancreaticoduodenal artery supplies head of the pancreas and to the descending and inferior parts of the
duodenum
51
Ans. D: Descending colon

154. The uterus is chiefly supplied by the two uterine arteries and partly by ovarian arteries
Ans. C: Both
155. Branches of the sacral plexus, the pudendal nerve, and nerve to the obturator internus leave the pelvis through the
lower part of the greater sciatic foramen, below the piriformis.
They cross the ischial spine with the internal pudendal artery and immediately re-enter the pelvis through the lesser
sciatic foramen; they then lie in the ischiorectal fossa.
The pudendal nerve supplies structures in the perineum.
The nerve to the obturator internus supplies the obturator internus muscle on its pelvic surface.
Ans. A: Ischial spine
156. The kidneys have the following coverings:

Fibrous capsule: This surrounds the kidney and is closely applied to its outer surface.
Perirenal fat: This covers the fibrous capsule.
Renal fascia: This is a condensation of connective tissue that lies outside the perirenal fat and encloses the kidneys and
suprarenal glands; it is continuous laterally with the fascia transversalis.
Pararenal fat: This lies external to the renal fascia and is often in large quantity.
It forms part of the retroperitoneal fat.
The perirenal fat, renal fascia, and pararenal fat support the kidneys and hold them in position on the posterior abdominal
wall.
Ans. D: Fibrous capsule
157. Ans. D: Internal iliac artery

158. The superficial inguinal ring is a triangular aperture in the aponeurosis of the external oblique muscle and is situated above
and medial to the pubic tubercle.
In the female, the superficial inguinal ring is smaller and difficult to palpate; it transmits the round ligament of the uterus.
Ans. B: Round ligament of the uterus
159. The kidneys are reddish brown and lie behind the peritoneum high up on the posterior abdominal wall on either side of
the vertebral column; they are largely under cover of the costal margin
The right kidney lies slightly lower than the left kidney because of the large size of the right lobe of the liver.
On the medial concave border of each kidney is a vertical slit that is bounded by thick lips of renal substance and is called
the hilum.
The hilum transmits, from the front backward, the renal vein, two branches of the renal artery, the ureter, and the third
branch of the renal artery (VAUA). Lymph vessels and sympathetic fibers also pass through the hilum.
Ans. C: Left kidney is situated lower than the right
160. The two uterine tubes are each about 4 in. (10 cm) long and lie in the upper border of the broad ligament.
Each connects the peritoneal cavity in the region of the ovary with the cavity of the uterus.
The uterine tube is divided into four parts:
The infundibulum is the funnel-shaped lateral end that projects beyond the broad ligament and overlies the ovary.
The tubal ostium is the point where the tubal canal meets the peritoneal cavity.
The ampulla is the widest part of the tube.
The isthmus is the narrowest part of the tube and lies just lateral to the uterus.
The intramural part is the segment that pierces the uterine wall.
Function
52
Anatomy
The uterine tube receives the ovum from the ovary and provides a site where fertilization of the ovum can take place
(usually in the ampulla).
The inner mucous membrane of the uterine tube is lined by the ciliated columnar epithelium mixed with the nonciliated
secretory cells or peg cells
The Mllerian ducts develops in females into the fallopian tubes, uterus and vagina, while the Wolffian ducts develops in
males into the epididymis and vas deferens
Ans. A: Lined by cuboidal epithelium
161. The left gastric artery arises from the celiac artery. It supplies the lower third of the esophagus and the upper right part of
the stomach.
The right gastric artery arises from the hepatic artery at the upper border of the pylorus and runs to the left along the lesser
curvature. It supplies the lower right part of the stomach.
The short gastric arteries arise from the splenic artery at the hilum of the spleen and pass forward in the gastrosplenic
omentum (ligament) to supply the fundus.
The left gastroepiploic artery arises from the splenic artery at the hilum of the spleen and passes forward in the gastrosplenic
omentum (ligament) to supply the stomach along the upper part of the greater curvature.
The right gastroepiploic artery arises from the gastroduodenal branch of the hepatic artery. It passes to the left and supplies
the stomach along the lower part of the greater curvature.
Ans. B: Splenic artery
162. The ovarian artery arises from the abdominal part of the aorta at the level of the first lumbar vertebra.
The artery is long and slender and passes downward and laterally behind the peritoneum. It crosses the external iliac
artery at the pelvic inlet and enters the suspensory ligament of the ovary.
It then passes into the broad ligament and enters the ovary by way of the mesovarium.
Ans. C: Abdominal part of the aorta
163. The vermiform appendix is located in the right lower quadrant of abdomen.
It is a narrow, worm shaped tube, arising from the posteromedial caecal wall, 2 cms or less below the end of the ileum.
Its opening is occasionally guarded by a semicircular fold of mucous membrane known as the valve of Gerlach.
The appendix is usually located at the junction of the taeniae, found on the surface of the caecum.
Its length varies from 2-20 cms, with an average length of 9 cms.
The attachment of the base of the appendix to the caecum remains constant, whereas the tip can be found in a retrocaecal
(65%)-commonest, pelvic (30%)-second most common, subcaecal, preileal, post-ileal or promontoric positions.
The mesoappendix has a free border which carries the blood supply to the organ, by the appendicular artery, a branch
from the ileocolic.
The appendix develops from the midgut loop together with the caecum, ascending colon and the proximal two thirds of
the transverse colon.
Appendicitis is the most common cause of acute abdomen in young people.
Ans. B: Retrocaecal
164. The portal vein drains blood from the abdominal part of the gastrointestinal tract from the lower third of the esophagus to
halfway down the anal canal; it also drains blood from the spleen, pancreas, and gallbladder.
The tributaries of the portal vein are the splenic vein, superior mesenteric vein, left gastric vein, right gastric vein, superior
pancreaticoduodenal, paraumbilical and cystic veins.
The portal vein enters the liver and breaks up into sinusoids, from which blood passes into the hepatic veins that join the
inferior vena cava. The portal vein is about 2 in. (5 cm) long and is formed behind the neck of the pancreas by the union of
the superior mesenteric and splenic veins.
Renal veins join the inferior vena cava just below the transpyloric plane
Ans. A: Renal vein
Ref.: BDC 4th ed., vol.2, page-270,316, Clinical Anatomy-Snell, 8th ed., page-245
53
165. Relations of stomach

Anteriorly: The anterior abdominal wall, the left costal margin, the left pleura and lung, the diaphragm, and the left lobe
of the liver
Posteriorly: The lesser sac, the diaphragm, the spleen, the left suprarenal gland, the upper part of the left kidney,
the splenic artery, the pancreas, the transverse mesocolon, and the transverse colon.
Hepatic flexure of colon is related to the colic impression on the inferior surface of the right lobe of the liver
Ans. A: Hepatic flexure of colon
166. Lymph Drainage of ovary

The lymph vessels of the ovary follow the ovarian artery and drain into the pre aortic and para-aortic nodes at the level
of the first lumbar vertebra.
Arterial Supply
The ovarian artery arises from the abdominal aorta at the level of the first lumbar vertebra.
Venous drainage.
The ovarian vein drains into the inferior vena cava on the right side and into the left renal vein on the left side.
Nerve Supply
The nerve supply to the ovary is derived from the aortic plexus and accompanies the ovarian artery.
Ans. A: Preaortic and para-aortic lymph nodes
167. Blood supply of testes
The testicular artery is a branch of the abdominal aorta given off at the level of L2.
The testicular veins emerge from the testis and the epididymis as a venous network, the pampiniform plexus.
This becomes reduced to a single vein as it ascends through the inguinal canal. The right testicular vein drains into the
inferior vena cava, and the left vein joins the left renal vein.
Ans. D: Testicular artery
168. Normally the long axis of the uterus is bent forward on the long axis of the vagina. This position is referred to as anteversion
of the uterus.
The long axis of the body of the uterus is bent forward at the level of the internal os with the long axis of the cervix. This
position is termed anteflexion of the uterus.
Thus, in the erect position and with the bladder empty, the uterus lies in an almost horizontal plane.
If the fundus and body of the uterus are bent backward on the vagina so that they lie in the rectouterine pouch (pouch of
Douglas), the uterus is said to be retroverted.
If the body of the uterus is, in addition, bent backward on the cervix, it is said to be retroflexed.
Ans. A: Normally the uterus is retroverted
169. The spleen is the largest single mass of lymphoid tissue in the body.
It lies just beneath the left half of the diaphragm close to the 9th, 10th, and 11th ribs.
The long axis lies along the shaft of the 10th rib, and its lower pole extends forward only as far as the midaxillary line.
The spleen is surrounded by peritoneum which passes from it at the hilum as the gastrosplenic omentum (ligament) to
the greater curvature of the stomach (carrying the short gastric and left gastroepiploic vessels).
The peritoneum also passes to the left kidney as the splenicorenal/lineorenal ligament (carrying the splenic vessels and
the tail of the pancreas).
Phrenicocolic ligament is not attached to the spleen but supports its anterior end
Ligamentum teres is related with the liver and represents the obliterated left umbilical vein
Ans. D: Ligamentum teres
170. Each ureter measures about 10 in. (25 cm) long and resembles the esophagus (also 10 in. long) in having three constrictions
along its course: where the renal pelvis joins the ureter, where it is kinked as it crosses the pelvic brim, and where it pierces
the bladder wall.
54
Anatomy
The ureter emerges from the hilum of the kidney and runs vertically downward behind the parietal peritoneum (adherent
to it) on the psoas muscle, which separates it from the tips of the transverse processes of the lumbar vertebrae.
It enters the pelvis by crossing the bifurcation of the common iliac artery in front of the sacroiliac joint .
The ureter then runs down the lateral wall of the pelvis to the region of the ischial spine and turns forward to enter the
lateral angle of the bladder.
Relations, Right Ureter
Anteriorly: The duodenum, the terminal part of the ileum, the right colic and ileocolic vessels, the right testicular or
ovarian vessels, and the root of the mesentery of the small intestine.
Posteriorly: The right psoas muscle, which separates it from the lumbar transverse processes, and the bifurcation of the
right common iliac artery.
Relations, Left Ureter
Anteriorly: The sigmoid colon and sigmoid mesocolon, the left colic vessels, and the left testicular or ovarian vessels.
Posteriorly: The left psoas muscle, which separates it from the lumbar transverse processes, and the bifurcation of the left
common iliac artery.
The inferior mesenteric vein lies along the medial side of the left ureter
Ureters are lined by transitional epithelium.
Ans. D: It is lined by cuboidal epithelium
171. Transpyloric plane passes through the tips of the ninth costal cartilages on the two sides that is, the point where the lateral
margin of the rectus abdominis (linea semilunaris) crosses the costal margin.
The transpyloric plane is clinically notable because it passes through several important abdominal structures.
These include:
Lumbar vertebra 1 and hence passes just before the end of the spinal cord in adults
The fundus of the gallbladder
The neck of the pancreas
The pancreatic body
The origins of the superior mesenteric artery from the aorta and portal vein
The left and right colic flexure
The left hilum of the kidney
The right hilum of the kidney
The root of the transverse mesocolon
Duodenojejunal flexure
The 2nd part of the duodenum
The upper part of conus medullaris
The spleen
Ans. B: Fundus of stomach
172. Relations of spleen:

Anteriorly: The stomach, tail of the pancreas, and left colic flexure. The left kidney lies along its medial border.
Posteriorly: The diaphragm; left pleura (left costodiaphragmatic recess); left lung; and 9th, 10th, and 11th rib.
Ans. D: The stomach
173. Veins which do not have valves are:

IVC
SVC
Hepatic, ovarian, uterine, renal, emissary, cerebral, pulmonary, and umbilical veins
Portal venous system is a valveless system
Ans. A: Femoral vein
174. Normal portal pressure is 5-10 mm Hg (Schwartz)

Normal Portal pressure is 5-8 mm Hg (Kumar and Clark)
55
Portal system
The portal vein drains blood from the small and large intestines, stomach, spleen, pancreas, and gallbladder.
The superior mesenteric vein and the splenic vein unite behind the neck of the pancreas to form the portal vein.
The portal trunk divides into 2 lobar veins.
The right branch drains the cystic vein, and the left branch receives the umbilical and paraumbilical veins that enlarge
to form umbilical varices in portal hypertension.
The coronary vein, which runs along the lesser curvature of the stomach, receives distal esophageal veins, which also
enlarge in portal hypertension.
Ans. A: 5-10 mm Hg
Ref: Schwartzs Surgery, 9th ed., p-1111; Kumar and Clarks Clinical Medicine, 5th ed., p-163
175. The angle between the lower border of the 12th rib and the outer border of the erector spinae is known as the renal angle
Renal angle
It is the angle between lateral border of Erector spinae and lower border of twelfth rib on the posterior aspect of the
trunk.
In most of the cases any abnormality (e.g., pain, tenderness, fullness, bulge) in this region is an indicative of renal
origin.
Ans. A: 12th rib and lateral border of sacrospinalis
Ref: BDC, 4th ed., Vol.-II, p-301, 280 [Fig 23.2]; 5th ed., p-328
176. Between the 2 fascial layers (fatty/ superficial and deep/ Colles fascia) of the urogenital diaphragm lie deep transverse perineii;
superficial to the proximal urethral sphincter mechanism
Urogenital diaphragm
It is a triangular musculo fascial diaphragm situated in the anterior part of perineum filling the gap of the pubic arch.
Components of urogenital diaphragm:
Deep transverse perinei muscles
Sphincter urethrae
Superior/ superficial fascia of urogenital diaphragm
Inferior/ deep fascia of urogenital diaphragm (Perineal membrane)
Colles fascia does not form a part of urogenital diaphragm, but it is attached to the posterior border of urogenital
diaphragm
Ans. B: Superficial transverse perineii
Ref: BDC, 4th ed., p-332; 5th ed., p-358
177. Anteriorly, pouch of Douglas is bounded by the uterus and the posterior fornix of the vagina
Fornices of vagina
The fornices of the vagina are the deepest portions of the vagina, extending into the recesses created by the vaginal
portion of cervix.
There are three named fornices:
The posterior fornix is the larger recess, behind the cervix. It is close to the rectouterine pouch.
There are two smaller recesses in front and at the sides:
The anterior fornix is close to the vesicouterine pouch.
The lateral fornix.
The fornices appear to be close to at least two erogenous zones, the AFE zone, which is near the anterior fornix, and
the cul-de-sac, which is near the posterior fornix
Ans. B: Pouch of Douglas
Ref: BDC/II, 5th ed., p-254, 255
HEAD AND NECK

178. Special somatic afferent nuclei are:
The cochlear nuclei (dorsal and ventral) that receive impulses of hearing through the cochlear nerve
The vestibular nuclei (superior, inferior, medial and lateral) that receive fibres from the semicircular canals, the utricle
and the saccule through the vestibular nerves
Ans: D i.e. Cranial nerve VIII
Ref: BDC, 3rd ed., Vol: III, p-261
56
Anatomy
179. Three processes of maxilla are: i) The frontal process, which is directed upwards, ii) The zygomatic process, which
articulates with zygomatic bone and iii) The alveolar process, which bears socket for upper teeth
The digastric branch of facial nerve is short and supplies posterior belly of digastric
The facial nerve leaves the skull by passing through the stylomastoid foramen
Behind the neck of the mandible, facial nerve divides into its 5 terminal branches which emerge along the anterior
border of parotid gland
As such, no relation of facial nerve with maxillary process has been mentioned
Ans: A i.e. Maxillary processes
Ref: BDC, 3rd ed., Vol: III, p- 5 (option a), 112
180. Optic nerve runs backwards and medially, and passes through the optic canal to enter the middle cranial fossa
Page -84 figure shows the nerves passing through superior orbital fissure (Lacrimal, frontal, trochlear, superior and
inferior rami of oculomotor, nasociliary and abducent)
Inferior orbital fissure transmits maxillary nerve, the zygomatic nerve etc.
Infraorbital foramen transmits the infraorbital nerve and vessels
Ans: B i.e. Superior orbital fissure
Ref: BDC, 3rd ed., Vol: III, p-24, 25, 84f, 88
181. Ducts of salivary glands

Duct of submandibular gland opens on the floor of the mouth, on the summit of sublingual papilla, at the side of the
frenulum of the tongue
About 15 ducts emerge from the sublingual gland. Most of them open directly into the floor of the mouth on the
summit of the sublingual fold.
The parotid duct runs forward for a short distance between the buccinator and the oral mucosa. Finally the duct turns
medially and opens into the vestibule of the mouth opposite the crown of the upper second molar tooth
Ans: C i.e. Opposite upper second molar tooth
Ref: BDC, 3rd ed., Vol: III, p-110, 132
182. The lateral wall of nasopharynx has pharyngeal opening of the auditory tube, at the level of the inferior nasal concha and
1.2 cm behind it
Ans: A i.e. Posterior to inferior nasal concha
Ref: BDC, 3rd ed., Vol: III, p-183f
183. As such no straightforward reference has been traced for this MCQ. But just follow the below mentioned lines from BDC:
During forced inspiration, both parts of the rima are triangular, so that the entire rima is lozenge shaped; the vocal
cords are fully abducted and we all know that muscles which open the glottis, are posterior cricoarytenoids. So in one
way we can consider them as safety muscles which help in respiration (forced inspiration)
Ans: C i.e. Posterior cricoarytenoids
Ref: BDC, 3rd ed., Vol: III, p-209
184. Superior rectus muscle

It is innervated by the superior division of the oculomotor nerve (Cranial Nerve III).
In the primary position (looking straight ahead), the superior rectus muscles primary function is elevation, although
it also contributes to intorsion and adduction.
Ans. C i.e. Adduction and intortion
Ref: BDC-III, 5th ed., p-118t
185. Stylopharyngeus is the only muscle in the pharynx innervated by the glossopharyngeal nerve (CN IX) and is done by its
motor branch, which supplies special visceral efferent (SVE) fibers to it.
Ans. B i.e. Stylopharyngeus
186. Lateral rectus

It control abduction and
It is the only muscle innervated by the abducens nerve,cranial nerve VI.
57
Ans. D i.e. VI cranial nerve

Ref: BDC-III, 5th ed., p-116
187. The levator palpebrae superioris muscle elevates and retracts the upper eyelid.
Ans. C i.e. Levator palpebrae superioris
188. Ciliary muscle

It is a ring of striated smooth muscle in the eyes middle layer (vascular layer)
It controls accommodation for viewing objects at varying distances and regulates the flow of aqueous humour into
Schlemms canal.
It changes the shape of the lens within the eye, not the size of the pupil which is carried out by the sphincter pupillae
muscle.
The muscle has only parasympathetic innervation.
Ans. C i.e. Change in shape of lens
189. Lateral Pterygoid

The primary function of the lateral pterygoid muscle is to pull the head of the condyle out of the mandibular fossa
along the articular eminence to protrude the mandible.
A concerted effort of the lateral pterygoid muscles acts in helping lower the mandible and open the jaw whereas
unilateral action of a lateral pterygoid produces contralateral excursion, usually performed in concert with the medial
pterygoids
Unlike the other three muscles of mastication, the lateral pterygoid is the only muscle of mastication that assists in
depressing the mandible (opening the jaw).
At the beginning of this action it is assisted by the digastric,mylohyoid and geniohyoid muscles.
Ans. A i.e. Lateral pterygoid
190. Stapedius
It is innervated by the nerve to stapedius, a branch of cranial nerve VII, the facial nerve.
This is the first branch of the facial nerve after it exits the facial canal
The second branch is the chorda tympani which carries special sense (taste) and parasympathetic fibres of cranial
nerve VII.
Ans. C i.e. Facial nerve
191. Roof of posterior triangle is formed by the investing layer of deep cervical fascia.
Accessory nerve lies just deep to the investing layer at the middle of the posterior border of sternocleidomastoid muscle
and across the posterior triangle and reaches the anterior border of trapezius, which it supplies.
Shrugging of shoulder is an action of trapezius.
Ans. C i.e. Shrugging of shoulder
192. Superior oblique muscle/obliquus oculi superior

It is a fusiform muscle originating in the upper, medial side of the orbit which abducts, depresses and internally
rotates the eye.
It is the only extraocular muscle innervated by the trochlear nerve (the fourth cranial nerve).
Ans. D i.e. Intortion
193. Pharyngotympanic (Auditory) tube is 4 cm long, consists of two parts:

Bony part forms posterior and lateral one third of the tube (12 cm long)
Cartilaginous part forms the anterior and medial two third (25 cm long)
Connects the middle ear with the nasopharynx
Equalizes pressure on both sides of the tympanic membrane
Usually closed to prevent entrance of particles from the nose
58
Anatomy
uscles that open auditory tube while swallowing, yawning and sneezing are levator veli palatini and tensor veli
M
palatini
Ans. D: Both A and B
194. Branches of the External Carotid Artery
Superior thyroid artery
Ascending pharyngeal artery
Lingual artery
Facial artery
Occipital artery
Posterior auricular artery
Superficial temporal artery
Maxillary artery
Ans. B: External carotid artery
195. Ans. A: Cricothyroid

196. Killians dehiscence is a weak part in the posterior wall of the pharynx which lies at the level of vocal folds or upper
border of the cricoid lamina and is limited inferiorly by the thick cricopharyngeal sphincter.
Pharyngeal diverticula results due to outpouching of the dehiscence
Two parts of the inferior constrictor has different nerve supplies, propulsive thyropharyngeus by the pharyngeal plexus and
the sphincter cricopharyngeus by the recurrent laryngeal nerve so there is possibility of neuromuscular incoordination.
If cricopharyngeus fails to relax and the thyropharyngeus contracts bolus of food may be pushed backwards and tends to
produce a diverticulum
Ans. B: Lies in the anterior wall of pharynx
197. The parathyroid glands are ovoid bodies measuring about 6 mm long in their greatest diameter.
They are four in number and are closely related to the posterior border of the thyroid gland, lying within its fascial
capsule.
The two superior parathyroid glands are the more constant in position and lie at the level of the middle of the posterior
border of the thyroid gland.
The two inferior parathyroid glands usually lie close to the inferior poles of the thyroid gland. They may lie within the
fascial sheath, embedded in the thyroid substance, or outside the fascial sheath
Ans. A: 4
198. The nasolacrimal duct is about 0.5 in. (1.3 cm) long and emerges from the lower end of the lacrimal sac.
The duct descends downward, backward, and laterally in a bony canal and opens into the inferior meatus of the nose.
The opening is guarded by a fold of mucous membrane known as the lacrimal fold. This prevents air from being forced up
the duct into the lacrimal sac on blowing the nose.
Ans. D: Inferior meatus of nose
199. Ans. A: Inferior thyroid artery

200. The muscles of the face are embedded in the superficial fascia, and most arise from the bones of the skull and are
inserted into the skin.
The orifices of the face, namely, the orbit, nose, and mouth, are guarded by the eyelids, nostrils, and lips, respectively.
It is the function of the facial muscles to serve as sphincters or dilators of these structures.
A secondary function of the facial muscles is to modify the expression of the face.
All the muscles of the face are developed from the second pharyngeal arch and are supplied by the facial nerve.
Ans. C: Develops from 3rd pharyngeal arch
59
201. All the intrinsic and the extrinsic muscles, except the palatoglossus are supplied by the hypoglossal nerve.
The palatoglossus is supplied by the cranial root of the accessory nerve through the pharyngeal plexus
Lingual nerve is the nerve of general sensation and the chorda tympani is the nerve of taste for the anterior two thirds of
the tongue except vallate papillae
Ans. A: Hypoglossal nerve
202. Ans. A: Stensons duct
203. The parotid gland lies in a deep hollow below the external auditory meatus, behind the ramus of the mandible, and in front
of the sternocleidomastoid muscle.
The facial nerve divides the gland into superficial and deep lobes.
The parotid duct, or Stenson duct, is about 2 in. (5 cm) long and passes forward across the masseter about a fingerbreadth
below the zygomatic arch.
It passes through the buccal fat, buccopharyngeal fascia, and buccinator muscle then opens into the vestibule of the
mouth next to the maxillary second molar tooth. The buccinator acts as a valve that prevents inflation of the duct during
blowing.
The submandibular glands are a pair of glands located beneath the lower jaws, superior to the digastric muscles.
The secretion produced enters the oral cavity via Whartons ducts. Approximately 70% of saliva in the oral cavity is
produced by the submandibular glands, even though they are much smaller than the parotid glands.
Ans. D: Masesster
204. The sclera is much thicker behind than in front; the thickness of its posterior part at the macula is 1 mm.
The sclera thins to 0.3 mm just behind the recti muscle insertions (about 6 mm behind the corneoscleral junction) and
this area is extremely vulnerable to traumatic rupture. In fact this is the most common site of a ruptured globe due to blunt
trauma.
At the equator the sclera measures 0.4-0.5 mm in thickness.
It is thickest behind, near the entrance of the optic nerve. However it is weakest at the entrance of theoptic nerve.
Ans. D: At the insertion of recti muscles
205. Recurrent Laryngeal Nerve paralysis:
If both recurrent laryngeal nerves are interrupted, the vocal cords lie in a cadaveric position in between abduction
and adduction and phonation is completely lost.
When only one recurrent laryngeal nerve is affected, the opposite vocal cord compensates for it and phonation is
possible but there is hoarseness of voice
Superior Laryngeal Nerve paralysis
It divides into external and internal laryngeal nerves. External laryngeal nerve supplies cricothyroid and inferior constrictor
and internal laryngeal nerve supplies mucous membrane of the larynx upto the level of vocal folds:
Asymmetric vocal cord tension
Produces diplophonia
Loss of vocal fold tension (lowers pitch of voice)
Inaccurate vocal cord apposition
Paralysed side slightly shortened and bowed
May be depressed below level of normal side
Rotation of AP axis of vocal cords
Posterior commissure points to side of paralysis
Loss of laryngeal sensation and increased risk of aspiration
Ans. B: Both recurrent laryngeal nerve palsy
206. The annulus of Zinn, also known as the annular tendon or common tendinous ring, is a ring of fibrous tissue surrounding
the optic nerve at its entrance at the apex of the orbit.
It can be used to divide the regions of the superior orbital fissure.
The arteries surrounding the optic nerve are sometimes called the circle of Zinn-Haller (CZH).
Some sources distinguish between these terms more precisely, with the annulus tendineus communis being the parent
structure, divided into two parts:
60
Anatomy
A lower, the ligament or tendon of Zinn, which gives origin to the Rectus inferior, part of the Rectus internus, and the
lower head of origin of the Rectus lateralis.
An upper, which gives origin to the Rectus superior, the rest of the Rectus medialis, and the upper head of the Rectus
lateralis. This upper band is sometimes termed the superior tendon of Lockwood.
The site of origin of the superior oblique muscle is from the lesser wing of sphenoid above the optic canal.
Ans. D: Superior oblique
207. Depression of the Mandible
Depression of the mandible is brought about by contraction of the digastrics, the geniohyoids, and the mylohyoids; the
lateral pterygoids play an important role by pulling the mandible forward.
Elevation of the Mandible
Elevation of the mandible is brought about by contraction of the temporalis, the masseter, and the medial pterygoids.
The head of the mandible is pulled backward by the posterior fibers of the temporalis.
Protrusion of the Mandible
In protrusion, the lower teeth are drawn forward over the upper teeth, which is brought about by contraction of the lateral
pterygoid muscles of both sides, assisted by both medial pterygoids.
Retraction of the Mandible
The articular disc and the head of the mandible are pulled backward into the mandibular fossa. Retraction is brought about
by contraction of the posterior fibers of the temporalis.
Lateral Chewing Movements
These are accomplished by alternately protruding and retracting the mandible on each side. For this to take place, a certain
amount of rotation occurs, and the muscles responsible on both sides work alternately like turning the chin to left side
produced by left lateral pterygoid and right medial pterygoid and vice versa.
Ans. C: Lateral pterygoids
208. Located posteriorly between the greater and lesser wings of the sphenoid; Superior orbital fissure communicates with the
middle cranial fossa. It transmits the lacrimal nerve, the frontal nerve, the trochlear nerve, the oculomotor nerve (upper
and lower divisions), the abducent nerve, the nasociliary nerve, and the superior ophthalmic vein.
Zygomatic nerve passes through inferior orbital fissure
Ans. D: Zygomatic nerve
209. Superior Meatus
The superior meatus lies below the superior concha. It receives the openings of the posterior ethmoid sinuses.
Middle Meatus
The middle meatus lies below the middle concha. It has a rounded swelling called the bulla ethmoidalis that is formed by
the middle ethmoidal air sinuses, which open on its upper border.
A curved opening, the hiatus semilunaris, lies just below the bulla. The maxillary sinus opens into the middle meatus
through the hiatus semilunaris.
The opening of the frontal air sinus is seen in the anterior part of the hiatus semilunaris
Inferior Meatus
The inferior meatus is below and lateral to the inferior nasal concha; the nasolacrimal duct opens into this meatus under
cover of the anterior part of the inferior concha.
Ans. C: Posterior ethmoid sinuses
210. Ophthalmic artery is the branch of cerebral part of internal carotid artery
Ans. D: Ophthalmic artery
211. Facial Nerve descends in the posterior wall of the middle ear, behind the pyramid, and emerges through the stylomastoid
foramen into the neck.
The greater petrosal nerve arises from the facial nerve at the geniculate ganglion.
It contains secretomotor (parasympathetic) fibers to the lacrimal gland, submandibular and sublingual salivary glands,
and the glands of the nose,the palate and the pharynx
61
The nerve is joined by the deep petrosal nerve from the sympathetic plexus and forms the nerve of the pterygoid canal
which ends in the pterygopalatine ganglion.
The nerve to the stapedius arises from the facial nerve which supplies the muscle within the pyramid.
The chorda tympani arises from the facial nerve just above the stylomastoid foramen. The nerve leaves the middle ear
through the petrotympanic fissure and enters the infratemporal fossa, where it joins the lingual nerve.
The chorda tympani contains taste fibers from the mucous membrane covering the anterior two thirds of the tongue (not
the vallate papillae) and the floor of the mouth.
Ans. D: Swallowing
212. The first plane is the venous plane and consists of the retromandibular vein and its tributaries and branches
Deep to venous plane is the important nervous plane. The importance of this plane is the presence of the facial (VII)
nerve. The facial nerve leaves the skull through the stylomastoid foramen and immediately enters the deep part of the
parotid gland where it gives off its branches:
Posterior auricular
Motor branch to posterior belly of digastric
Temporal branch
Zygomatic branch
Buccal branches
Mandibular branch
Cervical branch
Deep to the nerves lies the arterial plane which includes terminal parts of the external carotid artery and its branches:
External carotid artery
Occipital artery
Maxillary artery
Transverse facial artery
Superficial temporal artery
The deepest part of the parotid region is the parotid bed and houses the deep part of the gland which fills the small space
between the neck of the condyle of the mandible and the mastoid process. Other structures forming the floor of this space
are the:
Styloid process
Stylohyoid muscle
Stylopharyngeus muscle
Posterior belly of the digastric muscle
Ans. A: Facial artery
213. Submandibular Gland lies beneath the lower border of the body of the mandible and is divided into superficial and deep
parts by the mylohyoid muscle.
The deep part of the gland lies beneath the mucous membrane of the mouth on the side of the tongue.
The submandibular duct emerges from the anterior end of the deep part of the gland and runs forward beneath the
mucous membrane of the mouth. It opens into the mouth on a small papilla, which is situated at the side of the frenulum
of the tongue.
Parasympathetic secretomotor supply is from the facial nerve via the chorda tympani, and the submandibular ganglion.
Ans. C: Facial
214. The posterior triangle is bounded posteriorly by the trapezius muscle, anteriorly by the sternocleidomastoid muscle, and
inferiorly by the clavicle.
The posterior cervical triangle is subdivided into the following triangles by the inferior belly of the omohyoid muscle:
Occipital triangle, whose contents are:
Nerve to rhombideus
Cutaneous branches of cervical plexus of nerves
Spinal accessory nerve
Upper part of brachial plexus
Transverse cervical artery and vein
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Anatomy
Cervical lymph nodes

Occipital artery
Supraclavicular nodes
Subclavian triangle (also known as omoclavicular), whose contents are:
Third part of subclavian artery
Part of subclavian vein
Suprascapular artery and vein
Supraclavicular lymph nodes
Three trunks of brachial plexus
Nerve to serratus anterior
Nerve to subclavius
Suprascapular nerve
Lower part of external jugular vein
Transverse cervical artery and vein
Ans. C: Internal jugular vein
215. Single/pure movements-produced as a result of combined actions of muscles.
Upward rotation/elevation-superior rectus and inferior oblique
Downward rotation/depression-inferior rectus and superior oblique
Medial rotation/adduction-superior rectus, medial rectus and inferior rectus
Lateral rotation/abduction-superior rectus, lateral rectus and inferior rectus
Intortion-superior oblique and superior rectus
Extortion-inferior oblique and inferior rectus
Ans. C: Both of the above
216. The external auditory meatus is 4 cm long and conducts sound waves from the auricle to the tympanic membrane.
The framework of the anterior and medial two-thirds of the meatus is elastic cartilage (measures 25 mm in length), and
the posterior and lateral one third is bony, formed by the tympanic plate (measures 12 mm in length).
The sensory nerve supply of the lining skin is derived from the auriculotemporal nerve and the auricular branch of the
vagus nerve.
The lymph drainage is to the superficial parotid, mastoid, and superficial cervical lymph nodes.
Ans. C: 25 mm
217. The lingual nerve passes forward into the submandibular region from the infratemporal fossa by running beneath the
origin of the superior constrictor muscle, which is attached to the posterior border of the mylohyoid line on the mandible.
Here, it is closely related to the last molar tooth and is liable to be damaged in cases of clumsy extraction of an impacted
third molar.
Ans. C: Lingual nerve
218. Ans. B: Upper 2nd molar
219. The primary action of the superior oblique muscle is intorsion (internal rotation), the secondary action is depression
(primarily in the adducted position) and the tertiary action is abduction.
Ans. C: Intortion, abduction and depression
220. Genioglossus is the fan-shaped extrinsic tongue muscle that forms the majority of the body of the tongue.
Its origin is the mental spine of the mandible and its insertions are the hyoid bone and the dorsum of the tongue.
Innervated by the hypoglossal nerve (CN XII), it depresses and protrudes the tongue
Contraction of the genioglossus stabilizes and enlarges the portion of the upper airway that is most vulnerable to collapse.
A relaxation of the genioglossus and geniohyoideus muscles, especially during REM sleep, is implicated in Obstructive
Sleep Apnea (OSA.)
63
Peripheral damage to the hypoglossal nerve can result in deviation of the tongue to the damaged side
Ans. B: Genioglossus
Ref.: Grays anatomy 38th ed. Page-1725, BDC 4th ed., vol.3, page-252
221. The trigeminal nerve through its three branches is the chief sensory nerve of the face.
The skin over the angle of the jaw and over the parotid gland is supplied by the great auricular nerve (C2,C3)
Ans. A: Great auricular nerve
222. Ans. B: Posterior cricoarytenoid
223. Adductor of vocal cords
Thyroarytenoid muscle:
R and L muscles; attached to thyroid and arytenoid cartilages on each side.
Action shortens and relaxes vocal ligament.
Note: deeper inner fibers referred to as vocalis muscle.
Lateral cricoarytenoid muscle: (R and L muscles):
Attached to cricoid and arytenoid cartilage on each side.
Closes or adducts vocal folds.
Supplied by Recurrent laryngeal nerve.
Cricothyroid muscle:
Attached to cricoid and thyroid cartilages.
Tilts the thyroid cartilage, thus increasing tension of vocal folds
Supplied by external laryngeal nerve
Inter-arytenoid muscle (transverse and oblique)
Attached between right and left arytenoid cartilages
Closes inlet of larynx
Supplied by Recurrent laryngeal nerve
Abductor of vocal cords
Posterior cricoarytenoid muscle
Attached to cricoid and arytenoid cartilages
Move arytenoid cartilages so as to move both vocal folds apart, open of abduct vocal folds
Vocalis muscle (derived from inner and deeper fibers of thyroarytenoid msucle)
Alters vocal fold tension/relaxation during speaking or singing
All intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve except for cricothyroid which is
supplied by external laryngeal nerve.
Ans: C: Cricothyroid
224. Ans. C: Parotid gland
225. Most cases of congenital torticollis are a result of excessive stretching of the sternocleidomastoid muscle during a
difficult labor.
Hemorrhage occurs into the muscle and may be detected as a small, rounded during the early weeks after birth. Later, this
becomes invaded by fibrous tissue, which contracts and shortens the muscle.
The mastoid process is thus pulled down toward the sternoclavicular joint of the same side, the cervical spine is flexed, and
the face looks upward to the opposite side.
If left untreated, asymmetrical growth changes occur in the face, and the cervical vertebrae may become wedge shaped.
Spasmodic Torticollis
Spasmodic torticollis, which results from repeated chronic contractions of the sternocleidomastoid and trapezius
muscles, is usually psychogenic in origin. Section of the spinal part of the accessory nerve may be necessary in severe cases.
Ans. B: Sternocleidomastoid
64
Anatomy
226. A conical projection called the pyramid lies near the junction of the posterior and medial walls of the middle ear.
It has an opening at its apex for the passage of the tendon of the stapedius muscle
Ans. B: Stapedius
227. Their secretions of submandibular gland, like the secretions of other salivary glands, are regulated directly by the
parasympathetic nervous system and indirectly by the sympathetic nervous system.
Parasympathetic innervation to the submandibular glands is provided by the superior salivatory nucleus via the chorda
tympani, a branch of the facial nerve that synapses in the submandibular ganglion after which it follows the Lingual
nerve leaving this nerve as it approaches the gland. Increased parasympathetic activity promotes the secretion of
saliva.
The sympathetic nervous system regulates submandibular secretions through vasoconstriction of the arteries that
supply it. Increased sympathetic activity reduces glandular blood flow, thereby decreasing salivary secretions and
producing an enzyme rich mucous saliva.
Ans. D: Auriculotemporal nerve
Ref.: BDCs Anatomy, Vol-III, 4th ed.,p-163
228. Muscle which abduct the vocal cord is posterior cricoarytenoid only
Ans. D: Posterior Cricoarytenoid
Ref.: BDC, 4th ed., Vol.-III, p-243; 5th ed., p-242
229. Main source of arterial supply to tonsil is tonsilar branch of facial artery
Additional sources are ascending palatine branch of the facial artery, dorsal lingual branch of the lingual artery, ascending pharyngeal
branch of the external carotid artery and greater palatine branch of the maxillary artery
Ans. C: Superior thyroid artery
Ref.: BDC, 5th ed., Vol.-III, p-136, 216
230. Glossopharyngeal and lesser palatine nerves supply palatine tonsil
Palatine tonsil
The Palatine tonsils are two prominent masses situated one on either side between the glossopalatine and
pharyngopalatine arches.
Each tonsil consists fundamentally of an aggregation of lymphoid tissue underlying the mucous membrane between
the palatine arches.
In the child the tonsils are relatively (and frequently absolutely) larger than in the adult
The follicles of the tonsil are lined by a continuation of the mucous membrane of the pharynx, covered with stratified
squamous epithelium
Arteries supplying the tonsil are the:
Dorsalis linguae from the lingual
The ascending palatine and tonsillar from the external maxillary
The ascending pharyngeal from the external carotid
The descending palatine branch of the internal maxillary
A twig from the small meningeal.
The veins end in the tonsillar plexus, on the lateral side of the tonsil
The nerves are derived from the sphenopalatine ganglion, and from the glossopharyngeal.
Ans. C: Glossopharyngeal nerve
Ref.: BDC, 4th ed., Vol.-III, p-218; 5th ed., p-216
231. The Glossopharyngeal nerve is the nerve for both general sensation and taste sensation for the posterior 1/3rd of the tongue including
the circumvallate papillae
Nerve supply of tongue
Motor supply: All the intrinsic muscles, except the palatoglossus are supplied by the hypoglossal nerve (The
palatoglossus is supplied by the cranial part of accessory nerve through the pharyngeal plexus)
Sensory supply :
Anterior 2/3rd of the tongue - Lingual nerve is the nerve of general sensation and the chorda tympani is the
nerve of taste for the anterior two-thirds of the tongue.
Posterior 1/3rd of tongue - The glossopharyngeal nerve is the nerve for both general sensation and taste sensation
for the posterior 1/3rd of the tongue.
65
The posterior most part of the tongue is supplied by the vagus nerve through the internal laryngeal branch
Ans. C: Glossopharyngeal nerve
Ref.: BDC, 5th ed., p-253
232. Internal jugular vein is the direct continuation of the sigmoid sinus
The sigmoid sinuses:
They are two areas beneath the brain which allow blood to drain inferiorly from the posterior center of the head.
They drain from the transverse sinuses and converge with the inferior petrosal sinuses to form the internal jugular
vein
Each sigmoid sinus begins beneath the temporal bone and follows a tortuous course to the jugular foramen, at which
point the sinus becomes continuous with the internal jugular vein
The internal jugular vein:
It collects the blood from the brain, from the superficial parts of the face, and from the neck.
It is directly continuous with the transverse sinus, and begins in the posterior compartment of the jugular foramen, at
the base of the skull.
This vein receives in its course the inferior petrosal sinus, the common facial, lingual, pharyngeal, superior and middle
thyroid veins, and sometimes the occipital.
The thoracic duct on the left side and the right lymphatic duct on the right side open into the angle of union of the
internal jugular and subclavian veins.
The external jugular vein:
It receives the greater part of the blood from the exterior of the cranium and the deep parts of the face
It is formed by the junction of the posterior division of the posterior facial with the posterior auricular vein.
It commences in the substance of the parotid gland, on a level with the angle of the mandible
This vein receives the occipital occasionally, the posterior external jugular, and, near its termination, the transverse
cervical, transverse scapular, and anterior jugular veins; in the substance of the parotid, a large branch of communication
from the internal jugular joins it.
The anterior jugular vein:
It begins near the hyoid bone by the confluence of several superficial veins from the submaxillary region.
It descends between the median line and the anterior border of the Sternocleidomastoideus, and, at the lower part of
the neck, passes beneath that muscle to open into the termination of the external jugular, or, in some instances, into the
subclavian vein
Ans. B: Sigmoid sinus
Ref.: BDC/III, 5th ed., p-183
233. Vestibulo-cochlear nerve comprises of hearing and vestibular parts
Scala tympani
It is one of the perilymph-filled cavities in the cochlear labyrinth of the ear.
I t is separated from the scala media by the basilar membrane, and it extends from the round window to the
helicotrema, where it continues as scala vestibuli.
The purpose of the perilymph-filled scala tympani and scala vestibuli is to transduce the movement of air that
causes the tympanic membrane and the ossicles to vibrate, to movement of liquid and the basilar membrane.
This movement is conveyed to the organ of Corti inside the scala media, composed of hair cells attached to the
basilar membrane and their stereocilia embedded in the tectorial membrane.
The movement of the basilar membrane compared to the tectorial membrane causes the sterocilia to bend.
They then depolarise and send impulses to the brain via the cochlear nerve.
This produces the sensation of sound.
Ans. C: Vestibulocochlear nerve
Ref.: Grays Anatomy for students, 1st ed., p-869; BDC/III, 5th ed., p-267f, 359f
234. Trochlear nerve ends by supplying the superior oblique muscle on its orbital surface
Remember
SO-4, LR-6, Rest by 3
Superior oblique by 4th cranial nerve
Lateral rectus by 6th cranial nerve
Rest of the muscles by 3rd cranial nerve
Ans. B: Superior oblique
Ref.: BDC, 4th ed., Vol-III, p-108, 109; 5th ed., p-350
66
Anatomy
BRAIN AND SPINAL CORD
235. Vertebral level and spinal cord

Spinal cord in adults ends at L1, L2
Spinal cord in children ends at L3
Highest point of iliac crest is at L4
Ans: C i.e. L3
Ref: Clinical Anatomy by Snell, 8th ed., p-867
236. Middle meningeal artery

It is typically the third branch of the first part (retromandibular part) of the maxillary artery, one of the two terminal
branches of the external carotid artery.
After branching off the maxillary artery in the infratemporal fossa, it runs through the foramen spinosum to supply
the dura mater and the calvaria.
The middle meningeal artery is the largest of the three (paired) arteries which supply the meninges, the others being
the anterior meningeal artery and the posterior meningeal artery.
Ans. D i.e. Maxillary artery
Ref: BDC-III, 3rd ed., p-119
237. CSF
It is a clear colorless bodily fluid produced in the choroid plexus of the brain
It occupies the subarachnoid space (the space between the arachnoid mater and the pia mater) and the ventricular
system around and inside the brain and spinal cord.
It constitutes the content of the ventricles, cisterns, and sulci of the brain, as well as the central canal of the spinal cord.
Ans. C i.e. Arachnoid and piamater
238. Oculomotor nerve (CN III)

It arises from the anterior aspect of mesencephalon (midbrain).
There are two nuclei for the oculomotor nerve:
The oculomotor nucleus originates at the level of the superior colliculus.
The muscles it controls are the striated muscle in levator palpebrae superioris and all extraocular muscles
except for the superior oblique muscle and the lateral rectus muscle.
The Edinger-Westphal nucleus supplies parasympathetic fibres to the eye via the ciliary ganglion, and thus controls
the sphincter pupillae muscle (effecting pupil constriction) and the ciliary muscle (affecting accommodation).
Ans. A i.e. Fibre for constrictor pupillae originate from Edinger Westphal nucleus
239. Numerous arteries supply the dura mater from the internal carotid, maxillary, ascending pharyngeal, occipital, and
vertebral arteries.
From a clinical standpoint, the most important is the middle meningeal artery, which is commonly damaged in head
injuries.
The middle meningeal artery arises from the maxillary artery in the infratemporal fossa. To enter the cranial cavity, it
passes through the foramen spinosum to lie between the meningeal and endosteal layers of dura.
The anterior (frontal) branchs course corresponds roughly to the line of the underlying precentral gyrus of the brain.
The posterior (parietal) branch curves backward and supplies the posterior part of the dura mater.
Ans. D: Basilar artery
The middle cerebral artery is the largest terminal branch of the internal carotid artery and it runs laterally in the lateral
240.
cerebral sulcus of the brain.
It supplies the entire lateral surface of the cerebral hemisphere except the narrow strip along the superomedial border
extending from the frontal pole to the parieto-occipital sulcus(which is supplied by the anterior cerebral artery) and the
occipital pole and inferior temporal gyrus (both of which are supplied by the posterior cerebral artery).
Anterior cerebral artery chiefly supplies the medial surface
Ans. A: Middle cerebral artery
67
241. The spinal cord is a cylindrical, grayish white structure that begins above at the foramen magnum, where it is continuous
with the medulla oblongata of the brain. It terminates below in the adult at the level of the lower border of the first lumbar
vertebra.
In the young child, it is relatively longer and ends at the upper border of the third lumbar vertebra.
The spinal cord in the cervical region gives origin to the brachial plexus, and in the lower thoracic and lumbar regions,
where it gives origin to the lumbosacral plexus.
Inferiorly, the spinal cord tapers off into the conus medullaris, from the apex of which a prolongation of the pia mater, the
filum terminale, descends to be attached to the back of the coccyx.
Ans. C: L1
242. Ans. C: 12th nerve
243. Cranial Nerve I: Olfactory
Arises from the olfactory epithelium.
Passes through the cribriform plate of the ethmoid bone.
Fibers run through the olfactory bulb and terminate in the primary olfactory cortex.
Functions solely by carrying afferent impulses for the sense of smell.
Cranial Nerve II: Optic
Arises from the retina of the eye.
Optic nerves pass through the optic canals and converge at the optic chiasm.
They continue to the thalamus where they synapse.
From there, the optic radiation fibers run to the visual cortex.
Functions solely by carrying afferent impulses for vision.
Cranial Nerve III: Oculomotor
Fibers extend from the ventral midbrain, pass through the superior orbital fissure, and go to the extrinsic
eye muscles.
Functions in raising the eyelid, directing the eyeball, constricting the iris, and controlling lens shape.
Parasympathetic cell bodies are in the ciliary ganglia.
Cranial Nerve IV: Trochlear
Fibers emerge from the dorsal midbrain and enter the orbits via the superior orbital fissures; innervate the superior
oblique muscle.
Primarily a motor nerve that directs the eyeball.
Cranial Nerve V: Trigeminal
Three divisions: ophthalmic (V1), maxillary (V2), and mandibular (V3).
Fibers run from the face to the pons via the superior orbital fissure (V1), the foramen rotundum (V2), and the foramen
ovale (V3).
Conveys sensory impulses from various areas of the face (V1) and (V2), and supplies motor fibers (V3) for mastication.
Cranial Nerve VI: Abdcuens
Fibers leave the inferior pons and enter the orbit via the superior orbital fissure.
Primarily a motor nerve innervating the lateral rectus muscle.
Cranial Nerve VII: Facial
Fibers leave the pons, travel through the internal acoustic meatus, and emerge through the stylomastoid foramen to
the lateral aspect of the face.
Mixed nerve with five major branches.
Motor functions include facial expression, and the transmittal of autonomic impulses to lacrimal and salivary glands.
Sensory function is taste from the anterior two-thirds of the tongue.
Cranial Nerve VIII: Vestibulocochlear
Fibers arise from the hearing and equilibrium apparatus of the inner ear, pass through the internal acoustic meatus,
and enter the brainstem at the pons-medulla border.
Two divisions cochlear (hearing) and vestibular (balance).
Functions are solely sensory equilibrium and hearing.
68
Anatomy
Cranial Nerve IX: Glossopharyngeal

Fibers emerge from the medulla, leave the skull via the jugular foramen, and run to the throat.
Nerve IX is a mixed nerve with motor and sensory functions.
Motor innervates part of the tongue and pharynx and provides motor fibers to the parotid salivary gland.
Sensory fibers conduct taste and general sensory impulses from the tongue and pharynx.
Cranial Nerve X: Vagus
The only cranial nerve that extends beyond the head and neck.
Fibers emerge from the medulla via the jugular foramen.
The vagus is a mixed nerve.
Most motor fibers are parasympathetic fibers to the heart, lungs, and visceral organs.
Its sensory function is in taste.
Cranial Nerve XI: Accessory
Formed from a cranial root emerging from the medulla and a spinal root arising from the superior region of the spinal
cord.
The spinal root passes upward into the cranium via the foramen magnum.
The accessory nerve leaves the cranium via the jugular foramen.
Primarily a motor nerve.
Supplies fibers to the larynx, pharynx, and soft palate.
Innervates the trapezius and sternocleidomastoid, which move the head and neck.
Cranial Nerve XII: Hypoglossal
Fibers arise from the medulla and exit the skull via the hypoglossal canal.
Innervates both extrinsic and intrinsic muscles of the tongue, which contribute to swallowing and speech.
Ans. A: Optic nerve
244. Ans. B: Trigeminal

245. Tributaries of cavernous sinus
From the orbit:
Superior ophthalmic veins
Inferior ophthalmic vein or its branch
Central vein of the retina
From the brain:
Superficial middle cerebral vein
Inferior cerebral veins
From the meninges:
Sphenoparietal sinus
Frontal trunk of the middle meningeal vein
Draining channels:
Transverse sinus through the superior petrosal sinus
Internal jugular vein through inferior petrosal sinus and through a plexus around the internal carotid artery
Into pterygoid plaexus of veins through the emissary veins
Facial vein through the superor ophthalmic vein
Ans. A: Superior petrosal sinus
246. The amygdala (almond shaped) is part of the basal ganglia, and is situated in the temporal lobe. It has many connections
with other parts of the brain, most particularly with the limbic system, for which reason it is considered part of the limbic
system (although not part of the limbic lobe itself). The amygdala is critically involved in computing the emotional
significance of events. The raphe nuclei are a moderate-size cluster of nuclei found in the brain stem. Their main function
is to release serotonin to the rest of the brain.
The Dentate nucleus is located within the deep white matter of each cerebellar hemisphere. It is the largest of the four
deep cerebellar nuclei, the others being the fastigial nucleus and the interposed nucleus (globose and emboliform nuclei
combined). It is responsible for the planning, initiation and control of volitional movements.
The red nucleus is a structure in the rostral midbrain involved in motor coordination.
69
Ans. A: Amygdala
247. The midbrain is the narrow part of the brain that passes through the tentorial notch and connects the forebrain to the
hindbrain. The midbrain comprises two lateral halves called the cerebral peduncles; each of these is divided into an anterior
part, the crus cerebri, and a posterior part, the tegmentum, by a pigmented band of gray matter, the substantia nigra.
The narrow cavity of the midbrain is the cerebral aqueduct, which connects the third and fourth ventricles.
The tectum is the part of the midbrain posterior to the cerebral aqueduct; it has four small surface swellings, namely, the
two superior and two inferior colliculi.
Cross section of midbrain at the level of superior colliculus:
Grey matter
Central grey matter contains nucleus of oculomotor nerve and the mesencephalic nucleus of the trigeminal nerve
Pretectal nucleus
Red nucleus
Substantia nigra
Superior colliculus
Nucleus of trochlear nerve is present in the midbrain at the level of inferior colliculus
Ans. D: Red nucleus and occulomotor nerve nucleus
248. The spinal root arises from nerve cells in the anterior gray column (horn) of the upper five segments of the cervical part of
the spinal cord. The nerve ascends alongside the spinal cord and enters the skull through the foramen magnum.
It then turns laterally to join the cranial root.
The two roots unite and leave the skull through the jugular foramen.
The roots then separate:
The cranial root joins the vagus nerves and is distributed in its branches to the muscles of the soft palate and pharynx
(via the pharyngeal plexus) and to the muscles of the larynx (except the cricothyroid muscle).
The spinal root runs downward and laterally and enters the deep surface of the sternocleidomastoid muscle, which it
supplies, and then crosses the posterior triangle of the neck to supply the trapezius muscle.
The accessory nerve thus brings about movements of the soft palate, pharynx, and larynx and controls the movements of
the sternocleidomastoid and trapezius muscles.
Ans. C: Sternocleidomastoid
249. The cerebrum is the largest part of the brain and consists of two cerebral hemispheres connected corpus callosum.
The surface layer of each hemisphere is called the cortex and is composed of gray matter.
The frontal lobe is situated in front of the central sulcus and above the lateral sulcus.
The parietal lobe is situated behind the central sulcus and above the lateral sulcus. The occipital lobe lies below the parieto-
occipital sulcus. Below the lateral sulcus is situated the temporal lobe.
The precentral gyrus lies immediately anterior to the central sulcus and is known as the motor area and control voluntary
movements on the opposite side of the body.
Most nerve fibers cross over to the opposite side in the medulla oblongata as they descend to the spinal cord.
In the motor area, the body is represented in an inverted position.
The postcentral gyrus lies immediately posterior to the central sulcus and is known as the sensory area. The small nerve
cells in this area receive and interpret sensations of pain, temperature, touch, and pressure from the opposite side of the
body.
The superior temporal gyrus lies immediately below the lateral sulcus. The middle of this gyrus is concerned with the
reception and interpretation of sound and is known as the auditory area.
Brocas area, or the motor speech area, lies just above the lateral sulcus. It controls the movements employed in speech. It
is dominant in the left hemisphere in right-handed persons and in the right hemisphere in left-handed persons.
The visual area is situated on the posterior pole and medial aspect of the cerebral hemisphere in the region of the calcarine
sulcus. It is the receiving area for visual impressions.
Ans. C: Superior temporal gyrus
70
Anatomy
250. The facial muscles are innervated by the facial nerve.

Damage to the facial nerve in the internal acoustic meatus (by a tumor), in the middle ear (by infection or operation), in the
facial nerve canal (perineuritis, Bells palsy), or in the parotid gland (by a tumor) or caused by lacerations of the face will
cause distortion of the face, with drooping of the lower eyelid, and the angle of the mouth will sag on the affected side. This
is essentially a lower motor neuron lesion.
Check voluntary movement of the upper part of the face on the affected side: in supranuclear lesions such as a cortical
stroke (upper motor neuron; above the facial nucleus in the pons), the upper third of the face is spared while the lower
two thirds are paralyzed.
The orbicularis, frontalis, and corrugator muscles are innervated bilaterally, which explains the pattern of facial paralysis
in these cases
Ans. D: Upper half of the face normal, lower half affected
251. Nucleus Ambiguus

Function:
Motor innervation of ipsilateral muscles of the soft palate, pharynx, larynx and upper esophagus.
Pathway:
Axons of motor neurons in the nucleus ambiguus course with three cranial nerves: C.N. IX (glossopharyngeal), C.N. X
(vagus), C.N. XI (rostral or cranial portion of spinoaccessory) to innervate striated muscles of the soft palate, pharynx,
larynx and upper esophagus.
Deficits:
Lesion of nucleus ambiguus results in atrophy (lower motor neuron) and paralysis of innervated muscles, producing nasal
speech, dysphagia, dysphonia, and deviation of the uvula toward the opposite side (strong side).
No affection of the Sternocleidomastoid or Trapezius. These muscles are innervated by cells in the rostral spinal cord
(caudal portion C.N. XI).
Ans. D: XII
252. Ans. C: L3
253. Signs of Cerebellar Disorders
Ataxia, Reeling, wide-based gait- decomposition of movements, Inability to correctly sequence fine, coordinated acts
DysarthriaInability to articulate words correctly, with slurring and inappropriate phrasing
DysdiadochokinesiaInability to perform rapid alternating movements
DysmetriaInability to control range of movement
HypotoniaDecreased muscle tone
NystagmusInvoluntary, rapid oscillation of the eyeballs in a horizontal, vertical, or rotary direction, with the fast
component maximal toward the side of the cerebellar lesion
Scanning speechSlow enunciation with a tendency to hesitate at the beginning of a word or syllable
Tremor-Rhythmic, alternating, oscillatory movement of a limb as it approaches a target (intention tremor) or of
proximal musculature when fixed posture or weight bearing is attempted (postural tremor)
Asthenia: (Weakness/Lack of energy and strength/Loss of strength).
It is a prominent part of myasthenia gravis
Ans. C: Asthenia
JOINTS
254. Ans. B: Pubofemoral ligaments

255. When the knee is flexed, flexion is limited by the anterior surface of the thigh coming into contact with the anterior
abdominal wall.
When the knee is extended, flexion is limited by the tension of the hamstring group of muscles.
71
Extension, which is the movement of the flexed thigh backward to the anatomic position, is limited by the tension of the
iliofemoral, pubofemoral, and ischiofemoral ligaments.
Abduction is limited by the tension of the pubofemoral ligament, and adduction is limited by contact with the opposite
limb and by the tension in the ligament of the head of the femur.
Lateral rotation is limited by the tension in the iliofemoral and pubofemoral ligaments, and medial rotation is limited by
the ischiofemoral ligament.
The following movements take place:
Flexion is performed by the iliopsoas, rectus femoris, and sartorius and also by the adductor muscles.
Extension (a backward movement of the flexed thigh) is performed by the gluteus maximus and the hamstring muscles.
Abduction is performed by the gluteus medius and minimus, assisted by the sartorius, tensor fasciae latae and
piriformis.
Adduction is performed by the adductor longus and brevis and the adductor fibers of the adductor magnus.
These muscles are assisted by the pectineus and the gracilis.
Lateral rotation is performed by the piriformis, obturator internus and externus, superior and inferior gemelli, and
quadratus femoris, assisted by the gluteus maximus.
Ans. D: Sacroiliac ligament
256. Popliteus muscle
Origin: Lateral surface of lateral condyle of femur
Insertion: Posterior surface of shaft of tibia above soleal line
Nerve supply: Tibial nerve L4, 5; S1
Action: Flexes leg at knee joint; unlocks knee joint by lateral rotation of femur on tibia and slackens ligaments of joint
Ans. C: Popliteus
MISCELLANEOUS
257. Certain irregular bone contains large air spaces lined by epithelium. Examples: maxilla, sphenoid, ethmoid etc.
Ans: B i.e. Maxilla
Ref: BDC Handbook of General Anatomy, 4th ed., p-32
258. Muscles
Rectus femoris is a bipennate muscle
Multipennate muscle examples include subcapsularis, deltoid (acromial fibres)
Flexor pollicis longus is an unipennate muscle
Temporalis is a triangular muscle
Ans: B i.e. Deltoid
Ref: BDC Handbook of General Anatomy, 4th ed., p-90
259. Cartilage has no blood vessels, lymphatics or nerves

Ans. C i.e. Highly vascular
Ref: BDC General Anatomy, 4th ed., p-49
260. There are three types of cartilage:
Hyaline cartilage has a high proportion of amorphous matrix. Throughout childhood and adolescence, it plays an
important part in the growth in length of long bones (epiphyseal plates are composed of hyaline cartilage). It has a
great resistance to wear and covers the articular surfaces of nearly all synovial joints.
Fibrocartilage has many collagen fibers embedded in a small amount of matrix and is found in the discs within joints
(e.g., the temporomandibular joint, sternoclavicular joint, and knee joint) and on the articular surfaces of the clavicle
and mandible. Fibrocartilage, if damaged, repairs itself slowly in a manner similar to fibrous tissue elsewhere.
Elastic cartilage possesses large numbers of elastic fibers embedded in matrix. It is flexible and is found in the auricle
of the ear, the external auditory meatus, the auditory tube, and the epiglottis. Elastic cartilage, if damaged, repairs
itself with fibrous tissue.
Ans. C: Elastic cartilage
72
Anatomy
261. Elastic cartilage is present in the pinna, external auditory meatus, eustachian tubes, epiglottis, vocal process of arytenoids cartilage
Ans. B: Trachea
Ref.: Snells Anatomy, 7th ed., p-39; BDCs Handbook of General Anatomy, 4th ed., p-50
262. Shunts of simpler structure is found in the skin of nose, lips and external ear; thyroid gland, sympathetic ganglia etc.
Specialized AV anastomosis are found in the skin of digital pads and nail beds
Arteries of kidney are end-arteries
Arterio-venous anastomoses
It is the communication between an artery and a vein.
It serves the function of phasic activity of the organ
Shunts of simple structure are found in the:
Skin of the:
Nose
Lips
External ear
Mucous membrane of:
Nose
Alimentary canal
Coccygeal body
Erectile tissue of sexual organs
Tongue
Thyroid gland
Sympathetic ganglia
Specialized AV anastomoses is seen in the
Skin of digital pads
Nail beds
Ans. D: Kidney
Ref.: BDCs Handbook of General Anatomy, 4th ed., p-115
73

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CHAPTER 1

Level of vena caval opening: T8

Formed by union of 2 vertebral arteries: Basilar A.

rochordal plate & primitive streak is seen on: 14th day

1st polar body is formed during: Oogenesis

FETAL STRUCTURES & ADULT REMNANTS

Meckels divertculum: Remnant of vitelline duct

DERIVATIVES OF GERM LAYERS

esodermal in origin: Kidney, Muscle (EXCEPT musculature of iris), Bone etc.

EMBRYOLOGY OF GENITOURINARY SYSTEM

Collecting duct develops from: Ureteric bud

PHARYNGEAL ARCH DERIVATIVES

Meckels cartilage develops from: 1st pharyngeal arch

DERIVATIVES OF PHARYNGEAL POUCHES

Palatine tonsil develops from: 2nd pharyngeal pouch

Muscle of tongue develops from: Occipital myotomes

Brunners gland is present in: Duodenum

Paneth cells (intestine) are rich in: Rough ER

Nerve arising from the trunks of brachial plexus:

Hypothenar area (medial third of palm) is supplied by: Ulnar nerve

HIP & THIGH

Nerve of medial/ adductor compartment of thigh: Obturator nerve

Extensor of the knee joint: Quadricep femoris

Esophagus pierces diaphragm at a distance of: 15 inches (from incisor)

I nferior surface of the heart is formed by: Both ventricles

Artery crossing optic nerve: Ophthalmic artery

Contents of optic canal:

Contents of foramen magnum:

Cartilages of larynx: 3 paired & 3 unpaired

rimary auditory area is in: Superior part of the temporal gyrus

Lymphatics drainage of testis: Para-aortic node

Left gonadal vein drain into: Left renal vein

Quick Review (Including FMGE Questions)

EMBRYOLOGY c. Left fourth aortic arch artery

20. Ligamentum teres is: March 2011 d. Stratified squamous keratinized

61. Which of the following is an artery of the forearm: b. Ulnar nerve

98. Shape of tracheal cartilage: September 2008 INFERIOR EXTREMITY

157. Uterine artery is a branch of:  b. Superficial inguinal lymph nodes

177. Vaginal fornix is related to which of the following: c. V cranial nerve

216. Length of the cartilaginous part of Eustachian tube: d. Mylohyoid

BRAIN AND SPINAL CORD b. Trigeminal

JOINTS 258. Which of the following is a multipennate muscle:

ANSWERS WITH EXPLANATIONS

1. Development of pulmonary veins

3. Formation of primordial germ cells

4. Mllerian ducts (or paramesonephric ducts)

7. Anterior belly of digastric is derived from first pharyngeal arch

17. The boundaries of anatomical snuff box:

19. Umbilical vein carries oxygenated blood to embryo

Ductus venosus forms ligamnetum venosusm

31. Epithelium of cervix

33. Dense Regular Connective Tissue

34. Columnar epithelium

35. Ans. A: Nonkeratinized Stratified Squamous epithelium

37. Layers of the retina, from the outside inwards

39. Other sites with the typical cuboidal epithelium are:

42. Continuos capillaries

46. The lining epithelium of uterus is columnar

47. Contents of axilla

157. Uterine artery is a branch of: b. Superficial inguinal lymph nodes