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Human Anatomy Question Paper

Human Anatomy

Course:Bachelor Of Medicine And Bachelor Of Surgery

Institution: Moi University question papers

Exam Year:2007

M O I U N I V E R S I T Y

SCHOOL OF MEDICINE
END OF YEAR EXAMINATION (EYE) 2006/2007
COURSE TITLE: HUMAN ANATOMY
COURSE CODE: HMA 100
PROGRAMME: M.B.Ch.B. YEAR OF STUDY: 1 (ONE)
DATE: 8TH NOVEMBER, 2007 TIME: 9.00 AM - 12.00 NOON

INSTRUCTIONS:-

(i) Write your University Registration Number on every piece of paper you use.

(ii) Do not write your names on any piece of paper you use.

(iii) This paper consists of two (2) parts:
I - Gross Anatomy and II – Histology and Embryology.
(iv) Gross Anatomy part includes the following:
I. Section A – MCQs (type 1) – 30 minutes; 2 – Section B – MCQs (type 3) – 60 minutes; Section C – LEQs – 30 minutes.
(v) Histology and Embryology part includes the following:
1. Section A – MCQs 9type 3) – 20 minutes 2. Section B – MCQs (type 4) – 10 minutes; 3. Section C – SAQ – 10 minutes; 4 Section D – Diagram – 20 minutes.
(vi) Use answer sheets provided for types of MCQs, and diagrams booklets for SAQs and LEQs.
(vii) Read carefully any additional instructions.

PART I: GROSS ANATOMY
SECTION A: MULTIPLE CHOICE QUESTIONS (MCQs) (30 minutes)
TYPE I

I) THE FOLLOWING COMPLETE STATEMENTS ARE EITHER ‘TRUE’ OR ‘FALSE’
II) INDICATE BY PUTTING AN X IN THE APPROPRIATE BOX OF THE ANSWER SHEET
III) PUT AN X IN THE T COLUMN IF THE STATEMENT IS “TRUE” OR AN X IN THE F COLUMN IF THE STATEMENT IS “FALSE”

1. A femoral hernia is directed downwards, forewards, laterally and then upwards

2. Pulsation of the posterior tibial artery is felt in front of the medial malleolus.

3. Loss of evertion of the foot is a result of injury of the tibial nerve.

4. Loss of sensations derived from the sole of the foot is due to common peroneal nerve injury.

5. The medial meniscus is more commonly injured compared with the lateral.

6. A paralyzed peroneus longus muscle will weaken the longitudinal arch of the foot.

7. Loss of dorsiflexion of the foot (foot drop) is a result of common peroneal nerve injury.

8. To maintain better blood supply to the lower limb through the cruciate anastomoses, it is recommended to ligate the femoral artery immediately below the inguinal ligament.

9. The coverings of the femoral hernia are: the skin, the superficial fascia, the deep fascia, the cribriform fascia and the anterior wall of the femoral sheath.

10. Loss of sensations on the medial side of the foot is due to injury of the saphenous nerve.

11. The unlocking of the knee joint is done by the hamstring muscles.

12. The gastrocnemius and soleus muscles play an important role in the venous return process.

13. The upper lateral quadrant part of the gluteal region is the recommended part for intramuscular injections.

14. Winging of the scapula is a result of the long thoracic injury.

15. Lymph vessels from the breast drain in to the axillary and the parasternal lymph nodes.

16. Claw hand indicates injury of the median nerve.

17. Abduction of the arm is largely affected by the axillary nerve injury.

18. Drop of the upper limb after fracture of the clavicle is due to interruption of the function of the coracoclavicular ligament.

19. Fracture at the middle part of the shaft of the humerus may result in wrist drop.

20. Lateral pressure on the medial side of the upper half of the arm will control bleeding in the arm.

21. Increased pressure in the carpal tunnel may lead to damage of the radial nerve.

22. Dupuytren contracture is a disease due to shortening of the palmar aponeurosis.

23. Loss of sensations on the medial third of the palm is due to injury of the ulnar nerve.

24. Loss of adduction of the thumb is due to injury of the median nerve.

25. Ape hand is a character of median nerve injury.

26. Fracture at the medial epicondyle may lead to loss of adduction and abduction of the fingers.

27. Infection in the little finger can extend to the forearm.

28. Loss of pronation is a result of the ulnar nerve damage.

29. The radial artery pulsation is felt against the lower end of radius.

30. The bicipital aponeurosis will protect the brachial artery during intravenous injections through the median cubital vein.

SECTION B: MULTIPLE CHOICE QUESTIONS (MCQs) (60 minutes)
TYPE III

INSTRUCTIONS:

(I) THERE IS ONLY ONE WRONG STATEMENT IN EACH QUESTION. FIND IT AND MARK X IN THE ANSWER SHEET PROVIDED.

1. The saphenous opening:

(a) Is a defect in the deep fascia
(b) Lies 1.25 cm below the inguinal ligament
(c) Its medial margin is very thick and sharp
(d) Gives passage to the great saphenous vein
(e) Closed by the cribriform fascia

2. The inguinal lymph nodes:

(a) Drains the whole lower limb
(b) Is formed of superficial and deep groups
(c) Drains the external genital organs
(d) Drains the entire anterior abdominal wall
(e) Lies at the level of the inguinal ligament

3. The femoral sheath:

(a) The anterior wall is formed by the fascia transversalis
(b) The posterior wall is formed by the fascia iliaca
(c) The medial compartment contains fatty tissues only
(d) The femoral vein occupies the intermediate compartment
(e) The femoral nerve is found in the lateral compartment

4. The adductor (subsartorial) canal:

(a) The roof is fibrous
(b) The floor is formed by the adductor longus and magnus
(c) The saphenous nerve leaves the canal through its roof
(d) It contains profunda femoris vessels
(e) The vastus lateralis forms its anterolateral wall

5. The sciatic nerve:

(a) Arises from L.4, 5, S1, 2, 3
(b) Leaves the pelvis below the piriformis muscle
(c) It supplies all hamstring muscles
(d) It ends by dividing into two terminal branches on the surface of popliteus muscle
(e) Supplies the hip joint

6. The lesser sciatic foramen contains:

(a) The tendon of the obturator internus
(b) The pudendal nerve
(c) The internal pudendal vessels
(d) The inferior gluteal nerve
(e) The nerve to obturator internus

7. The gluteus medius muscle:

(a) Arises from the gluteal surface of the iliac bone
(b) Is inserted into the anterior surface of the greater trochanter of the femur
(c) Is supplied by the superior gluteal nerve
(d) Is medial rotator of the hip joint
(e) The damage of its nerve will lead to “Waddling gait”

8. The cruciate anastomosis is formed by:

(a) Superior gluteal artery
(b) Inferior gluteal artery
(c) Medial circumflex artery
(d) The deep external pudendal artery
(e) The fourth perforating artery

9. The intra-articular structures within the knee joint are:

(a) The anterior cruciate ligament
(b) The ligamentum patellae
(c) The posterior cruciate ligament
(d) The lateral meniscus
(e) The medial meniscus

10. The contents of the popliteal fossa:

(a) The popliteal artery
(b) The tibial nerve
(c) The common peroneal nerve
(d) The popliteal vein
(e) The anterior tibial artery

11. The popliteus muscle:

(a) Arises from a groove on the lateral condyle of the femur
(b) Is an intra-articular structure
(c) Supplied by the tibial nerve
(d) Unlocks the knee joint
(e) Extends the knee joint

12. The common peroneal nerve:

(a) Descends on the medial side of the biceps femoris
(b) Supplies the knee joint
(c) Curves on the lateral side of the neck of the fibula
(d) Its damage leads to loss of sensations on the sole of the foot
(e) Supplies all the muscles of the lateral and anterior compartments of the leg

13. The tibialis posterior muscle:

(a) Takes origin from the back of both fibula and tibia
(b) Supplied by the tibial nerve
(c) Inverts the foot
(d) Supports the longitudinal arch of the foot
(e) Inserted into all tarsal bones

14. Cutaneous nerve supply of the foot:

(a) The sural nerve supplies the lateral part of its dorsum
(b) The saphenous nerve supplies the medial part of its dorsum
(c) The deep peroneal nerve supplies the middle part of its dorsum
(d) The lateral part of its sole by the lateral plantar nerve
(e) The medial part of its sole by the medial plantar nerve

15. The second layer of the sole includes:

(a) The flexor digitorum longus tendon
(b) The flexor hallucis longus tendon
(c) The flexor digitorum brevis muscle
(d) The lumbrical muscles
(e) The flexor digitorum accessories

16. The anterior wall of the axilla includes:

(a) The pectoralis major muscle
(b) The pectoralis minor
(c) The subclavius muscle
(d) The teres major muscle
(e) The clavi-pectoral fascia

17. The contents of the axilla are:

(a) The axillary artery
(b) The axillary vein
(c) The cords of the brachial plexus
(d) The basilic vein
(e) The axillary lymph nodes

18. The posterior relations of the third part of the axillary artery are:

(a) The radial nerve
(b) The axillary nerve
(c) The teres major muscle
(d) The musculocutaneous nerve
(e) The latissimus dorsi muscle

19. The branches of the medial cord of the brachial plexus are:

(a) The ulnar nerve
(b) The medial cutaneous nerve of the arm
(c) The medial pectoral nerve
(d) The medial cutaneous nerve of the forearm
(e) The long thoracic nerve

20. The adductors of the shoulder joint are:

(a) The pectoralis major
(b) The latissimus dorsi
(c) The teres major
(d) The supraspinatus
(e) The subscapularis

21. The posterior relations of the brachial artery includes:

(a) Long head of triceps
(b) Radial nerve
(c) Axillary nerve
(d) Insertion of coracobrachialis muscle
(e) Brachialis muscle

22. The ulnar nerve:

(a) Its root value is C.7, 8, T.1.
(b) Lies behind the third part of the axillary artery
(c) Descends medial to the upper part of the brachial artery
(d) Passes to the posterior compartment of the arm
(e) Passes behind the medial epicondyle of the humerus

23. The ulnar nerve:

(a) Enters the forearm between the two heads of the flexor carpi ulnaris
(b) Passes along the medial side of the lower two thirds of the ulnar artery
(c) Supplies the medial half of the flexor digitorum profundus
(d) To enter the palm, it passes deep to the flexor retinaculum
(e) Supplies all interossei muscles

24. The posterior relations of the radial artery are:

(a) The tendon of biceps
(b) The supinator muscle
(c) The brachioradialis muscle
(d) The flexor pollicis longus muscle
(e) Pronator quadratus muscle

25. Structures passing through the carpal tunnel are:

(a) Tendon of the flexor digitorum profundus
(b) Tendon of the flexor digitorum superficialis
(c) Tendon of flexor pollicis
(d) Median nerve
(e) Ulnar artery

26. The median nerve:

(a) Its root value is C. 5, 6, 7, 8 T. I.
(b) Descends on the lateral side of the upper half of the brachial artery
(c) Supplies no muscles in the arm
(d) Enters the forearm deep to the pronator teres muscle
(e) Gives the anterior interosseous nerve in the forearm

27. The muscles supplied by the ulnar nerve in the hand are:

(a) Flexor digiti minimi
(b) Abductor digiti minimi
(c) Opponens digiti minimi
(d) Adductor pollicis
(e) Flexor pollicis brevis

28. The interossei muscle of the hand:

(a) They are 4 dorsal and palmar
(b) Inserted into the dorsal digital expansion
(c) Are supplied by the deep branch of ulnar nerve
(d) The palmar abducts the fingers
(e) They extend the interphalangeal joints

29. The shoulder joint as compared to the hip joint is:

(a) Unstable joint
(b) The articular surfaces are less fitting
(c) The ligaments around it are stronger
(d) The fibrous capsule is weak
(e) The movements allowed are wider

30. The upper (oblique) part of the ulnar artery lies deep to:

(a) The pronator teres muscle
(b) The flexor carpi radialis
(c) The palmaris longus muscle
(d) The flexor digitorum superficialis muscle
(e) The flexor carpi ulnaris

SECTION C: LONG ESSAY QUESTIONS (LEQs) (30 minutes)

INSTRUCTIONS

I) THERE ARE TWO (2) QUESTIONS IN THIS SECTION
II) ANSWER ALL THE TWO (2) QUESTIONS
III) START EACH QUESTION ON A FRESH PIECE OF PAPER OF THE BOOKLET

LEQ 1. Describe the attachments of the flexor retinaculum at the wrist and name the structures deeper to it.
(15 minutes)

LEQ 2. Describe the boundaries and contents of the popliteal fossa
(15 minutes)

PART II: HISTOLOGY AND EMBRYOLOGY
SECTION A: MULTIPLE CHOICE QUESTIONS (MCQs) (20 minutes)
TYPE III

INSTRUCTIONS

I) THERE IS ONLY ONE WRONG STATEMENT AMONG THE FOUR RIGHT IN EACH QUESTION
II) FIND IT AND MARK X IN THE ANSWER SHEET PROVIDED

1. Concerning cytology

(a) EM equivalent of basophils are ribosomes
(b) Mitochondria have their own DNA
(c) Catalase of the peroxisomes breaks down the hydrogen peroxide to water and oxygen
(d) Chromosomes split longitudinally during metaphase
(e) Replication of DNA takes place in the S-phase of the cell cycle

2. Regarding tissues

(a) The main component of basal lamina of epithelial cells is type IV collagen
(b) Mouth cavity and esophagus are lined with pseudostratified columnar epithelium
(c) The granules of connective tissue mast cells contain proteoglycan heparin
(d) Diaphysis is totally composed of compact bone
(e) Type I skeletal muscle fibers are rich in sarcoplasm that contain myoglobin

3. In relation to embryology

(a) Germ cells resulting from 1st meiotic division have 23 doubled structured chromosomes
(b) Fertilization occurs in the isthmus of oviduct
(c) Normally the human blastocyst implants in the endometrium along the posterior or anterior wall of the body of uterus
(d) The uteroplacental circulation is established at 12th day of development
(e) The epithelial lining of gastro-intestinal tract and respiratory tract has endodermal origin

4. About skin and its derivatives

(a) The cells of stratum granulosum contain keratohyalin granules
(b) The melanocytes are inserted among the cells of the stratum basale
(c) The Mekel’s cells of the epidermis are capable of phagocytosis
(d) The hair follicle is separated from the dermis by the glassy membrane
(e) Nail plate epithelium arises from the nail matrix

5. Concerning hypophysis

(a) Adenohypophysis originates from the Rathke’s pouch
(b) Superior hypophyseal arteries supply neurohypophysis
(c) Acidophilic cells of pars distalis produce follicle stimulating hormone and luteinizing hormone
(d) The pars nervosa is composed of 100,000 nonmyelinated axons of neurosecretory neurons from the supraoptic and paraventricular nuclei
(e) The pituicytes facilitate the release of neurohormones into the sinusoidal capillaries

6. Regarding thyroid and parathyroid glands

(a) Follicular cells are responsible for the production of calcitonin, lowering blood calcium level
(b) Synthesis of thyroxine occurs within follicular colloid
(c) Thyroid hypertrophy (goiter) is a result of increased TSH secretion
(d) The parathyroid glands develop from the third and fourth pharyngeal pouches
(e) The secretion of the parathyroid glands is regulated only by the blood calcium level

7. In relation to suprarenal glands

(a) The cortex arises from celomic intermediate mesoderm
(b) Steroids are released from the cortex by exocytosis
(c) The cells of zona reticularis contain lipophuscin pigment granules
(d) The mineralocorticoids act mainly on the distal convoluted tubules of kidney
(e) The parenchymal cells of medulla can be regarded as modified sympathetic postganglionic neurons

8. About thymus

(a) Blood-thymus barrier is formed by the continuous type capillaries and endings of the epithelial reticular cells
(b) Hassal’s corpuscles are composed of concentrically arranged epithelial reticular cells with signs of degeneration
(c) The accidental involution of the gland is not reversible
(d) Thymosin stimulates proliferation and differentiation of T-lymphocytes
(e) About 80% of T lymphocytes die in the cortex and are phagocytozed

9. Concerning spleen

(a) The white pulp consists of the splenic cords separated by the sinusoids
(b) The splenic sinusoids are of the fenestrated type
(c) The central arteries are sheathed by PALS
(d) The stroma of the spleen consists of reticular tissue
(e) The blood circulation in the human spleen is only of the open type

10. Regarding lymph nodes

(a) The inner cortex (paracortex) consists mainly of T-lymphocytes (thymus-dependent zone)
(b) Recirculation of lymphocytes is possible due to high endothelial venules
(c) The subcapsular and intermediate sinuses of the cortex are lined by reticular cells and macrophages
(d) The medullary cords contain many ?-lymphocytes and plasma cells
(e) The capsule of lymph nodes is rich in elastic fibers

SECTION B: MATCHING QUESTIONS (10 minutes)
TYPE IV

INSTRUCTIONS:

(I) THERE ARE FIVE (5) QUESTIONS IN THIS SECTION
(II) ANSWER ALL THE FIVE (5) QUESTIONS
(III) CHOOSE THE MOST APPROPRIATE LETTERED ITEM (A-H) TO THE NUMBERED ONE (1-5) AND MARK IT X IN THE ANSWER SHEET PROVIDED

Q. 1 Regarding cells and tissues

1.F Golgi apparatus A. Tubulin
2.D SER B. Ribosomes
3.A Microtubules C. Basal membrane
4.B Nissl bodies D. Synthesis of glycogen
5.H Laminin E. Heparin
F. Production of lysosomes
G. Antibodies
H. Fibronectin

Q 2. Concerning embryology

1.E Hyaluronidase A. Gastrulation
2.G Zonal reaction B. Yolk sac
3.B Heuser’s membrane C. Nephrogenic cord
4.A Primitive streak D. Amnion
5.C Intermediate mesoderm E. Acrosomal cap
F. Myotomes
G. Cortical granules
H. Neurulation

Q 3. In relation to the skin

1.G Tonofibrils A. Papillary layer
2.E Langerhans cells B. Holocrine type
3.C Meissner corpuscle C. Pressure receptor
4.B Sebaceous gland D. Clear cells
5.D Sweat gland E. Immunocompetent
F. Subcutaneous tissue
G. Stratum spinosum
H. Catecholamines

Q 4. About endocrine system

1.D Median eminence A. Neural crest cells
2.F ADH B. APUD - cells
3.A Adrenal medulla C. Testosterone
4.G Glucagon D Primary capillary plexus of the portal system
5.C Leydig cells E. Zona fasciculata
F. Diabetes insipidus
G. A-cells of islets of Langerhans
H. Sertoli cells

Q 5. Concerning immune system

1.C Thymus A. Germinal center
2.E Dendritic cells of lymph node B. Ileum
3.A Lymphoid nodule C. Endoderm of the 3rd and 4th
pharyngeal pouches
4.D Billroth’s cords D. Red pulp of the spleen
5.B Peyer’s patches E. Antigen presenting
F. Penicillar arterioles
G. PALS
H. Medullary cords

SECTION C: SHORT ANSWER QUESTION (10 minutes)

INSTRUCTIONS:

I) THERE IS ONE (1) QUESTION IN THIS SECTION
II) ANSWER THE QUESTION

SAQ 1. Describe the stages of meiosis of an ovum
(10 minutes)

SECTION D: DESCRIPTION OF DIAGRAMS (20 minutes)

Q 1. Name the diagrams (1-4). Write histological components (a-e) in the diagrams provided.

Human Anatomy Question Paper

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