📚 Question Bank

The trapezius is a broad, flat and triangular muscle. Trapezius muscle shape: considering left or right side - triangular shape; considering both sides together - diamond shaped, hence named trapezius.

The grey rami communicantes are not preganglionic fibers. They are postganglionic fibers. The cell bodies of the preganglionic sympathetic neurons are located in the lateral horn in the spinal grey matter... The axons of the postganglionic neurons return to the spinal nerve through the grey rami communicantes.

The superior border of the epiploic foramen (foramen of Winslow) is formed by the caudate lobe of the liver. It is likely to be injured in this case.

Epiploic foramen is a vertical slit of about 3 cm behind the free right border of the lesser omentum. It connects the lesser sac to the greater sac.

Clinical note: Pringle maneuver (as shown below) is a technique where the free margin of the lesser omentum is compressed to obtain rapid control of bleeding from the hepatic artery and portal vein in liver trauma and surgery.

The structure marked "1" is the levator ani muscle which is part of the pelvic diaphragm.

Other structures marked in the above image are 2: External anal sphincter, 3: Internal anal sphincter, 4: Pudendal canal. Levator ani and coccygeus muscles form the pelvic diaphragm and delineate the lower limit of the true pelvis.

Cremasteric reflex is mediated by L1 and L2. In this reflex, there is ipsilateral elevation of the testicle following stroking of the medial thigh.

The cremasteric reflex's afferent and efferent branches:

• Afferent - Femoral branch of genitofemoral nerve
• Efferent - Genital branch of genitofemoral nerve

Given below are the various reflexes with their root values.

Deep reflexes Biceps -C5, C6

Brachioradialis - C5, C6

Triceps - C6, C› Finger flexion - C8 Knee jerk - L3,L4 Ankle -S1, S2

Superficial reflexes

Corneal - CN š(A) - CN šII(E)

- Pons

Conjunctival - CN š (A) - CN šII(E) - Pons

Scapular - C5, T1 Abdominal - T›-T12 Anal - S3, S4 Cremastric -L1, L2

Deep reflexes Superficial reflexes Jaw jerk - CN V (Pons) Plantar - L5S1

Inferior thyroid artery is a branch of thyrocervical trunk, which in turn, is a branch of the first part of the subclavian artery. The inferior thyroid artery loops upwards anterior to the medial border of the scalenus anterior.

Posterior superficial compartment of the leg does not contain any neurovascular bundle. The posterior compartment of the leg is divided into the deep and superficial parts by the transverse intermuscular septum.

The given clinical scenario is suggestive of Broca's aphasia in which the Broca's area will be affected.

In Broca's aphasia/ Motor aphasia / Non-fluent aphasia, areas 44 and 45 in the prefrontal and premotor facial regions of the cerebral cortex are affected. The affected individuals will

have difficulty forming verbal or written words. The comprehension aspect of speech is preserved but the person cannot repeat or name the words and lacks fluency.

Patients in whom the area is severely affected may have very few words to express all of their emotions.

The image shows the midsagittal section of the brain. The wrongly marked structure is C-hypothalamus. The structure marked as C corresponds to the pituitary gland.

Loss of flexion at the interphalangeal (IP) joint of the thumb, is due to the involvement of the anterior interosseous nerve (AIN). Flexion of thumb occurs at 2 joints: IP joint is FPL supplied by AIN.

Purkinje cells of the cerebellum relay into the dentate nucleus which is one of the deep cerebellar nuclei.

The input to the Purkinje cells come from the climbing fibres. The output of Purkinje cells is inhibitory to the deep cerebellar nuclei.

Options A and B: Caudate and lentiform nuclei are part of the basal ganglia.

Option D: Red nucleus receives afferents from the cerebellum and plays a role in modulating signals to the upper motor neurons of the cerebral cortex.

Proprioception is perceived by the mesencephalic nucleus of the trigeminal nerve, not the spinal nucleus.

The trigeminal nerve consists of 4 nuclei: 3 sensory (Mesencephalic, spinal, and principal sensory nucleus) and 1 motor.

Nucleus

Mesencephalic Nucleus

Principal sensory nucleu s

Spinal nucleus

Motor nucleus

Location

Composed of a column ofuni polar nervecells situated in th e midbrain and extends inferi orly into the pons as far as th e main sensory nucleus

Posterior part of the pons lat eral to the motor nucleus

Continuous superiorly with t he main sensory nucleus and extends inferiorly the whole of the medulla oblongatatill t he 2ndCervical Segment

The pons medial to the main sensory nucleus

Function

Receives the sensation ofpro prioceptionfrom the muscles of mastication and from the f acial and extraocular muscles

Receives the sensations oftou ch and pressurefrom the face

Receives the sensation ofpain and temperaturefrom the fac e and some fibers oftouch

Supplies the muscles of masti cation, the tensor tympani, t he tensor veli palitini and the mylohyoid and the anterior belly of digastric muscle

This is a coronal section of the brain and the marked structure is the fornix. It arises from the hippocampus and ends in the mammillary body of the hypothalamus.

The meningeal branch of the internal carotid artery (ICA) does not supply the posterior cranial fossa. It supplies the anterior cranial fossa.

The dura mater is supplied by meningeal arteries that pass along the inner periosteum

(endosteum) of the skull over the endosteal layer of the dura and supply the following regions.

Region

Anterior cranial fossa

Middle cranial fossa

Arteries

Meningeal branches of anteri or and posterior ethmoid arte riesMeningeal branchesofinte rnal carotid arteriesA branch of themiddle meningealartery

Middle meningeal artery and accessory meningeal branche s of the maxillary arteryA bra nch of the ascending pharyng eal arteryBranches of the inte rnal carotid arteryA recurren t branch of the lacrimal arter y

Region Arteries

Posterior cranial fossa Meningeal branches of the oc

cipital arteryPosterior menin geal branches of the vertebral arteryDorsal meningeal and tentorial arteries arising from the meningohypophyseal tru nk

The distal end of the ulna does not take part in the formation of the radiocarpal joint.

The radiocarpal joint (Wrist joint) is a synovial, biaxial, and ellipsoid joint formed by the articulation of:

• The distal end of the radius
• Articular disc of the triangular fibrocartilage
• Scaphoid, lunate and triquetrum

In the neutral position of the wrist, only the scaphoid and lunate are in contact with the radius and articular disc; the triquetrum comes into apposition with the disc only in full adduction of the wrist joint.

The hypoglossal nerve is purely motor cranial nerve and is not involved in olfaction.

The other three cranial nerves—trigeminal, glossopharyngeal, and vagus nerves are mixed cranial nerves and contribute to olfaction.

Vagal nerve stimulation modifies the electrical activity of the olfactory bulb.

The most conspicuous sign of breast cancer is Peau d’ orange appearance. Peau d'orange (orange peel like texture), is the edematous swollen and pitted breast skin due to obstruction of the subcutaneous lymphatics.