• Directly behind the isthmus of thyroid gland is:

• A Sternohyoid muscle• B Thyrohyoid muscle• C Oesophagus• D Inferior thyroid artery• E Trachea

• Directly behind the isthmus of thyroid gland is:

• A Sternohyoid muscle• B Thyrohyoid muscle• C Oesophagus• D Inferior thyroid artery• E Trachea C

• . The cricoid cartilage is at the vertebral level of:• A C2• B C4• C C6 • D T1• E T3

• . The cricoid cartilage is at the vertebral level of:• A C2• B C4• C C6 Answer• D T1• E T3

• The following structures occupy the carotid sheath, except:

• A Common carotid artey• B Internal carotid artery • C Vagus nerve• D Sympathetic trunk • E Internal jugular vein

• The following structures occupy the carotid sheath, except:

• A Common carotid artey• B Internal carotid artery • C Vagus nerve• D Sympathetic trunk Answer• E Internal jugular vein

• . The zygomatic arch gives origin to:• A Masseter • B Temporalis• C Buccinator• D Platysma• E Medial pterygoid

Masseter

• The masseter is a thick, somewhat quadrilateral muscle, consisting of two heads, superficial and deep.

• The fibers of the two heads are continuous at their insertion

• The superficial head, the larger, arises by a thick, tendinous aponeurosis from the zygomatic process of the maxilla, and from the anterior two-thirds of the inferior border of the zygomatic arch.

• Its fibers pass downward and backward, to be inserted into the angle of the mandible and inferior half of the lateral surface of the ramus of the mandible.

• The deep head is much smaller, and more muscular in texture.

• It arises from the posterior 3rd of the lower border and from the whole of the medial surface of the zygomatic arch.

• Its fibers pass downward and forward, to be inserted into the upper half of the ramus and the lateral surface of the coronoid process of the mandible.

• The deep head of the muscle is partly concealed, anteriorly, by the superficial portion. Posteriorly, it is covered by the parotid gland.

Temporalis

• it arises from the temporal fossa and the deep part of temporal fascia.

• It passes medial to the zygomatic arch and inserts onto the coronoid process of the mandible

Medial pterygoid

• It consists of two heads.1. The bulk of the muscle arises as a deep head

from just above the medial surface of the lateral pterygoid plate.

2. The smaller, superficial head originates from the maxillary tuberosity and the pyramidal process of the palatine bone.

• Its fibers pass downward, lateral, and posterior, and are inserted, by a strong tendinous lamina, into the lower and back part of the medial surface of the ramus and angle of the mandible, as high as the mandibular foramen.

• The insertion joins the masseter muscle to form a common tendinous sling which allows the medial pterygoid and masseter to be powerful elevators of the jaw.

Lateral pterygoid

• The upper/superior head originates on the infratemporal surface and infratemporal crest of the greater wing of the sphenoid bone, and the lower/inferior head on the lateral surface of the lateral pterygoid plate.

• Inferior head inserts onto the neck of condyloid process of the mandible; upper/superior head inserts onto the articular disc and fibrous capsule of thetemporomandibular joint.

• . The zygomatic arch gives origin to:• A Masseter Answer• B Temporalis• C Buccinator• D Platysma• E Medial pterygoid

Buccinator

• Buccinator muscle is a thin quadrilateral muscle, occupying the interval between the maxilla and the mandible at the side of the face.

• It arises from the outer surfaces of the alveolar processes of the maxilla and mandible, corresponding to the three pairs of molar teeth; and behind, from the anterior border of the pterygomandibular raphé which separates it from the superior pharyngeal constrictor.

• The main sensory nerve to the upper lips is:• A Facial• B Infraorbital • C Buccal of mandibular• D External nasal• E Anterior superior alveolar•

The facial nerve

• It emerges from the brainstem between the pons and the medulla, and controls the muscles of facial expression, and taste sensations from the anterior two-thirds of the tongue and oral cavity.

• After the maxillary nerve enters the infraorbital canal, the nerve is frequently called the infraorbital nerve.

• This nerve innervates (sensory) the lower eyelid, upper lip, and part of the nasal vestibule and exits the infraorbital foramen of the maxilla.

• There is a cross innervation of this nerve on the other side of jaw

• The external nasal branches (or external nasal nerve) are terminal branches of the anterior ethmoidal nerves (from the ophthalmic division of the trigeminal nerve, CN V), and provide sensory innervation to the skin of the lower half of the nose and of the septum mobile nasi.

• The anterior superior alveolar branch (anterior superior dental branch), of considerable size, is given off from the maxillary nerve just before its exit from the infraorbital foramen; it descends in a canal in the anterior wall of the maxillary sinus, and divides into branches which supply the incisor and canine teeth.

• The main sensory nerve to the upper lips is:• A Facial• B Infraorbital Answer• C Buccal of mandibular• D External nasal• E Anterior superior alveolar•

• In postnatal period the greatest growth in grey matter of the CNS is of:

• A Nerve cell numbers• B Length of axonal processes• C Dendritic trees • D Size of perikarya • E Vertebral bone marrow

• In postnatal period the greatest growth in grey matter of the CNS is of:

• A Nerve cell numbers• B Length of axonal processes• C Dendritic trees Answer• D Size of perikarya • E Vertebral bone marrow

• The cells of posterior grey horn of the spinal cord are:• A In clusters• B In laminae from apex to base • C In laminae from medial to lateral side• D Diffusely• E In alternating large and small cell

groups

• The cells of posterior grey horn of the spinal cord are:• A In clusters• B In laminae from apex to base A• C In laminae from medial to lateral side• D Diffusely• E In alternating large and small cell

groups

• The cell in the CNS most like the Schwann cell in function is the:

• A Fibrous astrocytes• B Protoplasmic astrocytes• C Microglial cells • D Pericytes• E Oligodendrocytes

• The cell in the CNS most like the Schwann cell in function is the:

• A Fibrous astrocytes• B Protoplasmic astrocytes• C Microglial cells • D Pericytes• E Oligodendrocytes Answer•

• Oligodendrocytes (from Greek, meaning cells with a few branches), oroligodendroglia (Greek, few tree glue), are a type of neuroglia.

• Their main functions are to provide support and insulation to axons in the central nervous system of some vertebrates, equivalent to the function performed by Schwann cells in the peripheral nervous system.

• Tract which is small or absent in humans :• A Rubrospinal • B Tectospinal• C Vestibulospinal• D Olivospinal• E Anterior corticospinal

• Tract which is small or absent in humans :• A Rubrospinal Answer• B Tectospinal• C Vestibulospinal• D Olivospinal• E Anterior corticospinal

• The cerebellum sends efferent fibres to each of the following except:

• A The red nucleus of the opposite side • B The thalamus of the opposite side• C Reticular formation • D The vestibular nuclei of the same side• E The substantia nigra

• The cerebellum sends efferent fibres to each of the following except:

• A The red nucleus of the opposite side • B The thalamus of the opposite side• C Reticular formation • D The vestibular nuclei of the same side• E The substantia nigra Answer

• The axons from nucleus ambiguus innervate muscles of:

• A Eye• B Tongue • C Larynx • D Ear• E Jaws

• The axons from nucleus ambiguus innervate muscles of:

• A Eye• B Tongue • C Larynx A• D Ear• E Jaws

• The nucleus ambiguus (literally "ambiguous nucleus") is a region of histologically disparate cells located just dorsal (posterior) to the inferior olivary nucleus in the lateral portion of the upper (rostral)medulla.

• It receives upper motor neuron innervation directly via the corticobulbar tract.

• This nucleus gives rise to the branchial efferent motor fibers of the vagus nerve (CN X) terminating in the laryngeal, pharyngeal muscles, and musculus uvulae; as well as to the efferent motor fibers of the glossopharyngeal nerve (CN IX) terminating in the stylopharyngeus muscle.

• The interventricular foramen of Monro connects:

• A The two lateral ventricles• B Lateral ventricle with third ventricle • C Third and fourth ventricles• D Fourth ventricle with subarachnoid

space• E Tela choroidea with third ventricle

• The interventricular foramen of Monro connects:

• A The two lateral ventricles• B Lateral ventricle with third ventricle

A• C Third and fourth ventricles• D Fourth ventricle with subarachnoid

space• E Tela choroidea with third ventricle

• The abducent nerve is especially liable to be compressed by a rise in intracranial pressure because:

A It emerges at lower border of pons B It is related to basisphenoid C It crosses the sharp apex of petrous temporal bone D It transverse the superior orbital fissure E It transverse the subarachnoid space

• . The abducent nerve is especially liable to be compressed by a rise in intracranial • pressure because:• A It emerges at lower border of pons• B It is related to basisphenoid• C It crosses the sharp apex of petrous temporal bone Answer• D It transverse the superior orbital fissure• E It transverse the subarachnoid space

• The abducens nerve or abducent nerve (the sixth cranial nerve, also called the sixth nerve or simply CNVI) is a somatic efferent nerve that, in humans, controls the movement of a single muscle, the lateral rectus muscle of the eye.

• The abducens nerve leaves the brainstem at the junction of the pons and the medulla, medial to the facial nerve.

• In order to reach the eye, it runs upward (superiorly) and then bends forward (anteriorly).

• The nerve enters the subarachnoid space when it emerges from the brainstem.

• It runs upward between the pons and the clivus, and then pierces the dura mater to run between the dura and the skull through Dorello's canal.

• Dorello's Canal is the bow-shaped bony enclosure surrounding the abducens nerve and the inferior petrosal sinus as the two structures merge with the cavernous sinus.

• This canal is named after the famous Italian anatomist Primo Dorello, who proved the existence of this canal after a series of meticulous dissections.

• At the tip of the petrous temporal bone it makes a sharp turn forward to enter the cavernous sinus.

• In the cavernous sinus it runs alongside the internal carotid artery.

• It then enters the orbit through the superior orbital fissure and innervates the lateral rectus muscle of the eye.

• The long course of the abducens nerve between the brainstem and the eye makes it vulnerable to injury at many levels.

• For example, fractures of the petrous temporal bone can selectively damage the nerve, as can aneurysms of the intracavernous carotid artery.

• Mass lesions that push the brainstem downward can damage the nerve by stretching it between the point where it emerges from the pons and the point where it hooks over the petrous temporal bone.

• The nucleus ambiguus gives origin to motor fibers that run in the_________ nerves:

• A Vagus , trigeminal and facial• B Glossopharyngeal and vagus • C Vagus , hypoglossal and facial• D Facial , abducent and oculomotor• E Trigeminal , abducent and facial

• This nucleus gives rise to the branchial efferent motor fibers of thevagus nerve (CN X) terminating in the laryngeal, pharyngeal muscles, and musculus uvulae as well as to the efferent motor fibers of the glossopharyngeal nerve (CN IX) terminating in the stylopharyngeus muscle.

• The nucleus ambiguus gives origin to motor fibers that run in the_________ nerves:

• A Vagus , trigeminal and facial• B Glossopharyngeal and vagus Answer• C Vagus , hypoglossal and facial• D Facial , abducent and oculomotor• E Trigeminal , abducent and facial

• . The conus regions of both cardiac ventricles are derived from:

• A Sinus venosus• B Primitive atrium• C Primitive ventricle • D Bulbus cordis • E Truncus arteriosus•

• . The conus regions of both cardiac ventricles are derived from:

• A Sinus venosus• B Primitive atrium• C Primitive ventricle • D Bulbus cordis A• E Truncus arteriosus•

• Ductus venosus connects:• A Umblical vein to sinus venosus

• B Right to left umblical vein• C Pulmonary trunk to aorta • D Right to left atrium• E Hepatic vein to inferior vena cava

• Ductus venosus connects:• A Umblical vein to sinus venosus A

• B Right to left umblical vein• C Pulmonary trunk to aorta • D Right to left atrium• E Hepatic vein to inferior vena cava

• The cephalic flexure of the brain occurs in the region of :

• A Medulla oblongata• B Pons• C Mid brain• D Diencephalon • E Telencephalon

• The cephalic flexure of the brain occurs in the region of :

• A Medulla oblongata• B Pons• C Mid brain A• D Diencephalon • E Telencephalon

• The last descending tract to undergo myelination is:

• A Rubrospinal• B Tectospina• C Olivospinal• D Corticospinal • E Reticulospinal

• The last descending tract to undergo myelination is:

• A Rubrospinal• B Tectospina• C Olivospinal• D Corticospinal

Answer• E Reticulospinal

• In the stomach, parietal (oxyntic) cells are found in :

• A Fundus• B Body• C Pyloric canal• D Cardiac region • E Fundus and body

• In the stomach, parietal (oxyntic) cells are found in :

• A Fundus• B Body• C Pyloric canal• D Cardiac region • E Fundus and body A

• Secretory granules in neurohypophysis accumulate in:

• A Pituicytes• B Nerve endings • C Intercellular spaces • D Sinusoids• E Capillary endotheliam•

• Secretory granules in neurohypophysis accumulate in:

• A Pituicytes• B Nerve endings Answer• C Intercellular spaces • D Sinusoids• E Capillary endotheliam•

• The neurohypophysis (pars nervosa, posterior lobe) has three anatomic subdivisions. Secretion granules that contain the neurohypophyseal hormones,

• antidiuretic hormone (ADH, vasopressin) and oxytocin,

• are synthesized in the hypothalamus but are released into the bloodstream in the pars nervosa.

• ADH, an octapeptide synthesized in the hypothalamus, is packaged into membrane-limited granules with a corresponding binding protein (neurophysin) and transported to the pars nervosa, where it is released into the circulation.

• ADH binds to specific receptors in the distal part of the nephron and collecting duct of the kidney; it increases the renal tubular reabsorption of water from the glomerular filtrate.

• The pressor effect of ADH is less prominent than the antidiuretic effect. At a dosage several hundred times larger than the antidiuretic dosage, ADH has a pronounced pressor effect, which may also lead to coronary constriction. The contractile mechanism of the capillaries, as well as GI and uterine muscle, is stimulated, and a prolonged increase in blood pressure follows.

• Oxytocin has specific effects on the smooth muscle of the uterus and the myoepithelial cells of the mammary gland.

• It has no established physiologic function in the male, although an effect on sperm transport has been suggested.

• All endocrine tissues show one of the following features:

• A A rich capillary supply • B Encapsulation• C No lymphatics• D No nerve fibers• E Intercellular secretory

granules•

• All endocrine tissues show one of the following features:

• A A rich capillary supply A • B Encapsulation• C No lymphatics• D No nerve fibers• E Intercellular secretory

granules•

• The anal valves are at the level of the:• A Anorectal junction• B Anal margin• C White line of Hilton• D Rectal ampulla• E Pectinate line

• The anal canal is the most terminal part of the lower GI tract/large intestine, which lies between the anal verge (anal orifice, anus) in the perineum below and the rectum above.

• The anal valves are small valve-like folds at the lower ends of the anal sinuses in the rectum. The anal valves join together the lower ends of the anal columns.

• The interior of the anal canal and lower part of the rectum, showing the anal columns and the anal valves between their lower ends

• Confusion and controversy exist regarding the anatomy of the anorectal region in anatomy and surgical texts.

• This description is from below upwards, as that is how this region is usually examined in clinical practice.

• The pigmented, keratinized perianal skin of the buttocks (around the anal verge) has skin appendages (eg, hair, sweat glands, sebaceous glands); compare this with the anal canal skin above the anal verge, which is also pigmented and keratinized/cornified but does not have skin appendages

• In anatomy texts, the rectum changes to the anal canal at the dentate line.

• For surgeons, however, the demarcation between the rectum above and the anal canal below is the anorectal ring.

• The following is the description of the surgical anal canal (which in anatomical texts is described as the lower part of rectum).

• A whitish line called Hilton's white line or pecten of Jon Stroud indicates the junction between keratinized stratified squamous epithelium and unkeratinized stratified squamous epithelium.

• The anal canal is completely extraperitoneal. The length of the (surgical) anal canal is about 4 cm (range, 3-5 cm), with two thirds of this being above the dentate line and one third below the dentate line (the anatomical anal canal).

• The epithelium of the (anatomical) anal canal (between the anal verge below and the dentate line above) is variously described as anal mucosa or anal skin.

• It should be called anal skin (anoderm), as it looks like (pigmented) skin, is sensitive like skin (why a fissure-in-ano is very painful), and is keratinized (but does not have skin appendages).

• The dentate line (also called the pectinate line) is the site of fusion of the proctodeum below and the postallantoic gut above.

• It is a wavy demarcation formed by the anal valves (transverse folds of mucosa) at the inferior-most ends of the anal columns.

• Hindgut begins at posterior intestinal portal and enters into cloaca.

• Cloaca is also considered a part of hindgut.

• The septum is nothing but a wedge of mesenchyme which develops in the angle between allantois and hindgut, above the cloaca.

• Week 8. Proctodeum has developed. The anal membrane is still present between the hindgut and proctodeum.

• Anterior and Lateral views of rectum and anal canal. • Rectum (yellow) is entirely endodermal in origin, derived

from hindgut. • Upper two-third of anal canal (yellow with anal columns) is

endodermal and lower one-third (blue with white line) is ectodermal, derived from anal pit or proctodeum.

• Anal glands open above the anal valves into the anal crypts.

• The dentate line is not seen on inspection in clinical practice, but under anesthesia the anal canal descends down, and the dentate line can be seen on slight retraction of the anal canal skin.

• From a surgical perspective, the anal canal just above the dentate line for about 1-2 cm is called the transition zone.

• Beyond this transition zone, the (surgical) anal canal is lined with columnar epithelium (which is insensitive to cutting).

• Anal columns (of Morgagni) are 5-10 longitudinal (vertical) mucosal folds in the upper part of the anal canal.

• At the bottom of these columns are anal crypts, or sinuses, into which open the anal glands and anal papillae.

• Infection of the anal glands is likely the initial event in causation of perianal abscess and fistula-in-ano.

• Three of these columns (left lateral, right posterior, and right anterior, at 3, 7, and 11 o’clock position in supine position) are prominent; they are called anal cushions and contain branches and tributaries of superior rectal (hemorrhoidal) artery and vein.

• When prominent, veins in these cushions form the internal hemorrhoids.

• The anorectal ring is situated about 5 cm from anus.

• At the anorectal angle, the rectum turns backwards to continue as the anal canal.

• Levator ani and coccygeus muscles form the pelvic diaphragm.

• Lateral to the anal canal are the pyramidal ischioanal (ischiorectal) fossae (1 on either side), below the pelvic diaphragm and above the perianal skin.

• The 2 ischioanal fossae communicate with each other behind the anal canal.

• The anterior relations of the anal canal are, in males, the seminal vesicles, prostate, and urethra, and, in females, the cervix and vagina with perineal body in between.

• In front of (anterior to) the anal canal is the rectovesical fascia (of Denonvilliers), and behind (posterior) is the presacral endopelvic fascia (of Waldeyer), under which lie a rich presacral plexus of veins.

• Posterior to the anal canal lie the tip of the coccyx (joined to it by the anococcygeal ligament) and lower sacrum.

• The anal canal above the dentate line is supplied by the terminal branches of the superior rectal (hemorrhoidal) artery, which is the terminal branch of the inferior mesenteric artery.

• The middle rectal artery (a branch of the internal iliac artery) and the inferior rectal artery (a branch of the internal pudendal artery) supply the lower anal canal.

• Underneath the anal canal skin (below the dentate line) lies the external hemorrhoidal plexus of veins, which drains into systemic veins.

• Underneath the anal canal mucosa (above dentate line) lies the internal hemorrhoidal plexus of veins, which drains into the portal system of veins.

• The anorectum is, therefore, an important area of portosystemic venous connection (the other being the esophagogastric junction).

• Lymphatics from the anal canal drain into the superficial inguinal group of lymph nodes.

• The anal canal below the dentate line develops from the proctodeum, while that above the dentate line develops from the endoderm of the hindgut.

• Lastly, the anal canal also has differing nervous innervations above and below the line.

• Above the pectinate line, the nerve supply is visceral, coming from the inferior hypogastric plexus.

• As is it visceral, this part of the anal canal is only sensitive to stretch.

• Below the pectinate line, the nerve supply is somatic, receiving its supply from the inferior rectal nerves (branches of the pudendal).

• As it is somatically innervated, it is sensitive to pain, temperature, and touch.

• The rectal ampulla is the dilated section of the rectum where feces are stored until they are eliminated via the anal canal.

• The caliber of the rectum at its commencement is similar to that of the sigmoid colon, but near its termination it dilates, forming the ampulla.

• The anal valves are at the level of the:• A Anorectal junction• B Anal margin• C White line of Hilton• D Rectal ampulla• E Pectinate line A

• The lateral fornix of the vagina is most closely related to the:

• A Urethra• B Ureter • C Middle rectal artery• D Uterine artery• E Round ligament of uterus

• The lateral fornix of the vagina is most closely related to the:

• A Urethra• B Ureter Answer• C Middle rectal artery• D Uterine artery• E Round ligament of uterus

• Location of sphincter urethrae:• A Superficial perineal pouch• B Deep perineal pouch • C Ischiorectal fossa• D Above the prostate gland• E Lower abdominal wall

• Location of sphincter urethrae:• A Superficial perineal pouch• B Deep perineal pouch A• C Ischiorectal fossa• D Above the prostate gland• E Lower abdominal wall

• Nodes receiving lymph from testis:• A External iliac• B Internal iliac• C Superficial inguinal• D Presacral• E Para-aortic

• The paired testicular arteries arise directly from the abdominal aorta and descend through the inguinal canal, while the scrotum and the rest of the external genitalia is supplied by the internal pudendal artery (itself a branch of the internal iliac artery).

• Lymphatic drainage of the testes follows the testicular arteries back to the paraaortic lymph nodes, while lymph from the scrotum drains to the inguinal lymph nodes.

• Nodes receiving lymph from testis:• A External iliac• B Internal iliac• C Superficial inguinal• D Presacral• E Para-aortic Answer

• The internal spermatic fascia is derived from the:

• A External oblique• B Internal oblique• C Transversus abdominis• D Transversalis fascia • E Peritoneum

• The internal spermatic fascia is derived from the:

• A External oblique• B Internal oblique• C Transversus abdominis• D Transversalis fascia A• E Peritoneum

• The spermatic fascia is a bilayered fascia covering the testis;

• 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.

• Immediately medial to deep inguinal ring is:• A Femoral artery• B Linea alba• C Spermatic cord • D The inguinal (Hesselbach,s) triangle• E Inferior epigastric • artery

• The deep inguinal ring (internal or deep abdominal ring, abdominal inguinal ring, internal inguinal ring) is the entrance to the inguinal canal.

• The surface marking of the deep inguinal ring is classically described as immediately above the midpoint of the inguinal ligament (midway between the anterior superior iliac spine and the pubic tubercle)

• It is of an oval form, the long axis of the oval being vertical; it varies in size in different subjects, and is much larger in the male than in the female.

• It is bounded, above and laterally, by the arched lower margin of the transversalis fascia; below and medially, by the inferior epigastric vessels.

• It transmits the spermatic cord in the male and the round ligament of the uterus in the female.

• In human anatomy, inferior epigastric artery refers to the artery that arises from the external iliac artery and anastomoses with the superior epigastric artery.

• Along its course, it is accompanied by a similarly named vein, the inferior epigastric vein.

• Immediately medial to deep inguinal ring is:• A Femoral artery• B Linea alba• C Spermatic cord • D The inguinal (Hesselbach,s) triangle• E Inferior epigastric • artery A

• Immediately anterior to the conjoint tendon is:

A Internal oblique B Transversus abdominis C Superficial inguinal ring D Transversalis fascia E Spermatid cord

• The conjoint tendon (previously known as the inguinal aponeurotic falx) is a structure formed from the lower part of the transversus abdominis muscle as it inserts into the crest of the pubis and pectineal line immediately behind thesuperficial inguinal ring.

• It is usually conjoint with the tendon of the abdominal internal oblique muscle, but they may be separate as well.

• It forms the medial part of the posterior wall of the inguinal canal.

• The interfoveolar ligament, seen from in front. (Inguinal aponeurotic falx labeled at lower left.)

• Immediately anterior to the conjoint tendon is:

A Internal oblique B Transversus abdominis

C Superficial inguinal ring D Transversalis fascia E Spermatid cord

• The most common condition of vermiform appendix is:

• A Retrocaecal • B Retrocolic• C Retroileal• D Pelvic • E Subcaecal

• The most common condition of vermiform appendix is:

• A Retrocaecal

• B Retrocolic• C Retroileal• D Pelvic • E Subcaecal

• The anterior limit of normal spleen is represented by the:

• A Posterior axillary line• B Mid axillary line • C Anterior axillary line• D Mid-clavicular line• E Linea semilunaris

Spleen

• To map out the spleen the tenth rib is taken as representing its long axis; vertically it is situated between the upper border of the ninth and the lower border of the eleventh ribs.

• The highest point is 4 cm. from the middle line of the back at the level of the tip of the ninth thoracic spinous process; the lowest point is in the midaxillary line at the level of the first lumbar spinous process.

• The anterior limit of normal spleen is represented by the:

A Posterior axillary line

B Mid axillary line C Anterior axillary line D Mid-clavicular line E Linea semilunaris

• To manage uncontrolled epistaxis of a young patient, an ENT surgeon should ligate 1 of the following arteries:

A.Lesser palatineB. Greater palatine C. Facial D.Sphenopalatine E. Posterior superior alveolar

• sphenopalatine artery (nasopalatine artery) is an artery of the head, commonly known as the artery of epistaxis

• The sphenopalatine artery is a branch of the maxillary artery which passes through the sphenopalatine foramen into the cavity of the nose, at the back part of the superior meatus. Here it gives off its posterior lateral nasal branches.

• Crossing the under surface of the sphenoid, the sphenopalatine artery ends on the nasal septum as the posterior septal branches.

• Here it will anastomose with the branches of the greater palatine artery.

• sphenopalatine artery is the artery responsible for the most serious, posterior nosebleeds (also known as epistaxis). It can be ligated surgically to control such nosebleeds.

• To manage uncontrolled epistaxis of a young patient, an ENT surgeon should ligate 1 of the following arteries:

A.Lesser palatineB. Greater palatine C. Facial D.Sphenopalatine E. Posterior superior alveolar

• The greater omentum is attached to:• A Liver and stomach• B Stomach and jejunum• C Jejunum and colon• D Stomach and colon

• E Liver and colon

• The greater omentum (also the great omentum, omentum majus,gastrocolic omentum, epiploon, or, especially in animals, caul) is a large apron-like fold of visceral peritoneum that hangs down from the stomach. It extends from the greater curvature of the stomach, passing in front of the small intestines and reflects on itself to ascend to the transverse colon before reaching to the posterior abdominal wall.

• The greater omentum is attached to:• A Liver and stomach• B Stomach and jejunum• C Jejunum and colon• D Stomach and colon

• E Liver and colon

• The middle lobe of prostate is the part between:• A Rectum and prostatic urethra• B Ejaculatory duct and rectum• C Ejaculatory duct and prostatic urethra • D Pubis and prostatic urethra• E Pubis and rectum

• The middle lobe of prostate is the part between:

A Rectum and prostatic urethra

B Ejaculatory duct and rectum

C Ejaculatory duct and prostatic urethra

D Pubis and prostatic urethra

E Pubis and rectum

• The ductus (vas) deference is connected to

prostatic urethra by?

A The prostatic utricle

B Gartner,s duct

C The ejaculatory duct

D The urachus

E Bulbo-urethral glands

• Front and above view

• The ductus (vas) deference is connected to

prostatic urethra by?

A The prostatic utricle

B Gartner,s duct

C The ejaculatory duct

D The urachus

E Bulbo-urethral glands

• The main sensory nerve to lower lip is:

A Buccal

B Cervical of facial

C Mental

D Submandibular

E Inferior labial

• Mental nerve is a general somatic afferent (sensory) nerve which provides sensation to the anterior aspects of the chin and lower lip as well as the buccal gingivae of the mandibular anterior teeth and the premolars.

• Mental nerve is a branch of the posterior trunk of the inferior alveolar nerve, which is itself a branch of the mandibular division of the trigeminal nerve (CN V).

• The main sensory nerve to lower lip is:

A Buccal

B Cervical of facial

C Mental

D Submandibular

E Inferior labial

• A structure passing deep to hyoglossus

muscle:

A Hypoglossal nerve

B Mylohyoid nerve

C Submandibular duct

D Lingual nerve

E Glossopharyngeal nerve

• The Hyoglossus, thin and quadrilateral, arises from the side of the body and from the whole length of the greater cornu of the hyoid bone, and passes almost vertically upward to enter the side of the tongue, between the Styloglossus and Longitudinalis inferior.

• It forms a part of the floor of Submandibular triangle.

• Extrinsic muscles of the tongue. Left side. (Hyoglossus visible at center.)

• Structures that are medial/superficial to the hyoglossus are the glossopharyngeal nerve (9th Cranial nerve), the stylohyoid ligament and the lingual artery & vein.

• Since these structures are most superficial, they are most likely to be damaged.

• The lingual vein passes medial to the hyoglossus, and the lingual artery passes deep to the hyoglossus.

• Laterally, in between the hyoglossus muscle and the mylohyoid muscle lay several important structures (from superior in inferior):

• sublingual gland, submandibular duct, lingual nerve, vena comitans of hypoglossal nerve, and the hypoglossal nerve.

• Note, posteriorly, the lingual nerve is superior to the submandibular duct and a portion of the submandibular salivary gland protrudes into the space between the hyoglossus and mylohyoid muscles.

• The hyoglossus depresses and retracts the tongue makes the dorsum more convex

• It is important in singing.

• The mylohyoid nerve (or nerve to mylohyoid) is a nerve that innervates the mylohyoid muscle and the anterior belly of the digastric muscle.

• The mylohyoid nerve branches from the inferior alveolar nerve (a branch of the mandibular nerve, the third part of the trigeminal nerve) just before it enters the mandibular foramen.

• It descends in a groove on the deep surface of the ramus of the mandible, and reaching the under surface of the mylohyoid muscle, it supplies both the mylohyoid and the anterior belly of the digastric muscle.

• A structure passing deep to hyoglossus

muscle:

A Hypoglossal nerve

B Mylohyoid nerve

C Submandibular duct

D Lingual nerve

E Glossopharyngeal nerve

. The sublingual papilla: A Is a swelling on lingual nerve B Is caused by loop of lingual artery C Is a swelling caused by the sublingual gland D Marks the opening of submandibular duct E Is a specialized taste bud

• sublingual papilla or sublingual fold is a small fold of soft tissue located on each side of the frenulum linguae

• The submandibular duct or Wharton duct or submaxillary duct is one of the salivary excretory ducts. It is about 5 cm. long, and its wall is much thinner than that of the parotid duct.

• It drains saliva from each bilateral submandibular gland and sublingual gland to the sublingual caruncle at the base of the tongue.

. The sublingual papilla: A Is a swelling on lingual nerve B Is caused by loop of lingual artery C Is a swelling caused by the sublingual gland D Marks the opening of submandibular duct Answer E Is a specialized taste bud

• . The first permanent tooth to erupt is the:• A Lateral incisor• B Canine• C First premolar• D First molar • E Third molar

Eruption times of primary teeth

• Upper• Central incisor 7.5 mths• Lateral incisor 8 mths• Canine 16-20 mths• First molar 12-16 mths• Second molar 21-30 mths

• Lower• Central incisor 61/2 mths• Lateral incisor 7 mths• Canine 16-20 mths• First molar 12-16 mths• Second molar 21-30 mths

Eruption times of permanent teeth

• Upper• Central incisor 7 - 8 yrs• Lateral incisor 8 - 9 yrs• Canine 11 - 12 yrs• First premolar 10 - 11 yrs• Second premolar 10 - 12 yrs• First molar 6 - 7 yrs• Second molar 12 - 13 yrs• Third molar 17 - 21 yrs

• Lower• Central incisor 6 - 7 yrs• Lateral incisor 7 - 8 yrs• Canine 9 - 10• First premolar 10 - 12 yrs• Second premolar 11 - 12 yrs• First molar 6 - 7 yrs• Second molar 12 - 13 yrs• Third molar 17 - 21 yrs

. The first permanent tooth to erupt is the: A Lateral incisor B Canine C First premolar D First molar Answer E Third molar

. The lingual tonsil is confined to: A Posterior one-third of tongue B Anterior one-third of tongue C Sulcus terminalis D Crista terminalis E Ventral surface of tongue

• lingual tonsils are rounded masses of lymphatic tissue that cover the posterior region of the tongue.

• They are located on the dorsal surface at the base of the tongue.

. The lingual tonsil is confined to: A Posterior one-third of tongue B Anterior one-third of tongue C Sulcus terminalis D Crista terminalis E Ventral surface of tongue

A

– One of the following cranial nerves does not contain special visceral efferents:

• A 7th

• B 9th

• C 10th

• D 11th

• E 12th

• Special visceral efferent (SVE) refers to efferent nerves that provide motor innervations to the muscles of branchial arches.

• The only nerves containing SVE fibers are cranial nerves:

• the trigeminal nerve (V), • the facial nerve (VII), • the glossopharyngeal nerve (IX), • the vagus nerve (X) and • the accessory nerve (XI)

First arch

• Muscles of mastication, anterior belly of the digastric, mylohyoid, tensor tympani, tensor veli palatini

• Trigeminal nerve (V2 and V3)

Second arch

• Muscles of facial expression, buccinator, platysma, stapedius, stylohyoid, posterior belly of the digastric

• Facial nerve (VII)

Third arch

• Stylopharyngeus• The stylopharyngeus is a muscle in the head

that stretches between the temporal styloid process and the pharynx.

• Stylopharyngeus is the only muscle in the pharynx innervated by the glossopharyngeal nerve (CN IX) and is done by its single motor branch, which supplies special visceral efferent (SVE) fibers to it.

Fourth arch

• Cricothyroid muscle, all intrinsic muscles of soft palate (including levator veli palatini) except tensor veli palatini

• Vagus nerve (X), superior laryngeal nerve

Sixth arch

• All intrinsic muscles of larynx except the cricothyroid muscle

• Vagus nerve (X), recurrent laryngeal nerve

1. One of the following cranial nerves does not contain special visceral efferents: A. 7th B. 9th C. 10th D. 11th E. 12th A