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Human Anatomy Question Paper

Human Anatomy

Course:Bachelor Of Medicine

Institution: Moi University question papers

Exam Year:2008

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

SCHOOL OF MEDICINE
END OF YEAR EXAMINATION (EYE) 2007/2008
COURSE TITLE: HUMAN ANATOMY
COURSE CODE: HMA 100
PROGRAMME: M.B.Ch.B. YEAR OF STUDY: 1 (ONE)
DATE: 6TH NOVEMBER, 2008 TIME: 9.00 A.M - 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
II – HISTOLOGY AND EMBRYOLOGY.

(IV) GROSS ANATOMY PART INCLUDES THE FOLLOWING:

SECTION A: MCQS TYPE 1 (30 MINUTES)
SECTION B: MCQS TYPE 3 (60 MINUTES)
SECTION C: LEQS (30 MINUTES)

(V) HISTOLOGY AND EMBRYOLOGY PART INCLUDES THE FOLLOWING:

SECTION A: MCQS TYPE 3 (20 MINUTES)
SECTION B: MCQS TYPE 4 (10 MINUTES)
SECTION C: DIAGRAMS (20 MINUTES)
SECTION D: SAQ (10 MINUTES)

(VI) USE ANSWER SHEETS PROVIDED FOR TYPES OF MCQS AND BOOKLETS FOR SAQS AND LEQS. DIAGRAMS SHOULD BE ANSWERED IN THE DIAGRAM SHEETS PROVIDED.

(VII) READ CAREFULLY ANY ADDITIONAL INSTRUCTIONS.

PART I: GROSS ANATOMY

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

I) THERE ARE THIRTY (30) QUESTIONS IN THIS SECTION.

II) ANSWER ALL THE THIRTY QUESTIONS.

III) INDICATE AGAINST THE APPROPRIATE NUMBERS IN THE ANSWER SHEETS PROVIDED WHETHER THE COMPLETE STATEMENTS ARE TRUE (T) OR FALSE (F) BY PRINTING AN “X” IN THE BOX IN THE COLUMN HEADED “T” FOR TRUE AND “F” FOR FALSE.

1. Inability to flex the distal phalanx of the fourth and fifth digits of the hand would indicate damage to the median nerve.

2. Adduction of digits two, four and five of the hand are a function of the median nerve.

3. Loss of function of the muscles of the posterior compartment of the leg and the sole of the foot is associated with paralysis of the deep peroneal nerve.

4. A bullet wound which damages the musculocutaneous nerve at its origin would affect flexion at the elbow joint.

5. Damage to the median nerve above the wrist joint may result in loss of sensations on the medial third of the palm.

6. Damage to the radial nerve resulting from a fractured humerus will result in loss of adduction and abduction of the fingers only.

7. If it is necessary to ligate the femoral artery above the origin of its branch, the profunda femoris, blood will reach the lower limb through cruciate anastomosis.

8. Winging of the scapula is a deformity of the upper limb resulting from paralysis of the upper subscapular nerve.

9. Loss of sensation of the skin over the medial 1/3rd of the dorsum of the hand may result from damage of the radial nerve.

10. Complete pronation of the forearm is lost as a result of paralysis of the median nerve.

11. Loss of sensation from the lateral part of the aspect of the forearm indicates damage to the musculocutaneous nerve.

12. Except for the navicular bone, all tarsal bones provide muscle attachment.

13. Lateral displacement of the patella during contraction of quadriceps femoris muscle is an action done by the rectus femoris.

14. One could feel a dorsalis pedis pulse at the base of the first metatarsal bone between the tendons of the extensor digitorum longus and the extensor hallucis longus.

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

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

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

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

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

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

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

22. Infection of the distal phalanx of the little finger can extend to the forearm.

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

24. Increased pressure in the carpal tunnel may result in injury of the ulnar nerve.

25. Injury of the tibial nerve results into loss of eversion and dorsiflection of the foot.

26. One of the results of the tibial nerve paralyses is flatfoot deformity.

27. It is the action of both gluteus medius and minimus muscles which will prevent tilting of the pelvis during standing on one limb.

28. The superficial inguinal lymph nodes receive all the superficial lymph vessels of the lower limb except from the back.

29. The dorsal digital expansion on the dorsal aspect of the proximal phalanx of the lateral four toes receives contributions from all interosseous muscles.

30. Fracture of the scaphoid bone is presented by pain in the floor of the anatomical snuff.

SECTION B: MULTIPLE CHOICE QUESTIONS (MCQs) (60 minutes)
TYPE 3

INSTRUCTIONS:

(I) THERE ARE THIRTY (30) QUESTIONS IN THIS SECTION.

(II) ANSWER ALL THE THIRTY (30) QUESTIONS.

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

1. The triceps muscle:

a) Its medial head arises from the humerus.
b) Its long head arises from the scapula.
c) The radial nerve passes between its medial and lateral heads as it enters the spiral groove.
d) Is inserted in the olecranon process.
e) Is supplied by separate branches of the radial nerve.

2. The profunda branchii artery:

a) Arises from the brachial artery.
b) Its ascending branch anastomoses with the circumflex humeral arteries around the surgical neck of the humerus.
c) It joins the radial nerve in the spiral groove.
d) Passes deep to the medial head of triceps.
e) Its branches share into the anastomosis around the elbow.

3. 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.

4. The contents of the axilla are:

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

5. 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.

6. The adductors of the shoulder joint are:

a) The pectoralis major.
b) Latissimus dorsi.
c) The teres major.
d) The supraspinatus.
e) The subscapularis.

7. The posterior relations of the brachial artery includes:

a) Long head of triceps.
b) Teres major muscle.
c) Radial nerve.
d) Insertion of coracobrachialis muscle.
e) Brachialis muscle.

8. Concerning the humerus:

a) The ulna nerve passes behind the medial epicondyle.
b) Radial nerve lies on its back.
c) The axillay nerve curves around its surgical neck.
d) The brachial artery is first anterior then medial to it.
e) The coracobrachialis muscle is attached to the middle of its medial border.

9. The radius bone gives origin to the following:

a) The supinator.
b) The flexor pollicis longus.
c) The abductor pollicis longus.
d) The extensor pollicis brevis.
e) The flexor digitorum superficialis.

10. The arteries which share in the anstomosis around the elbow are:

a) The superior ulnar collateral.
b) The inferior ulnar collateral.
c) The posterior circumflex humeral.
d) The anterior ulnar recurrent.
e) The posterior ulnar recurrent.

11. The palmar aponeurosis:

a) Is attached by is apex to the flexor retinaculum.
b) Its base give five processes, one for each finger.
c) Its lateral border sends a septum to the palmar surface of the third metacarpal bone.
d) Its medial border sends another septum to the fifth metacarpal bone.
e) Gives insertion to the palmaris longus muscle.

12. The flexor digitorum profundus muscle:

a) Arises from the ulnar.
b) Is supplied by the ulnar and median nerves.
c) Is contained together with the flexor digitorum superficialis into one common synovial sheath.
d) Its tendon has to pass between the two slips of the flexor digitorum superficialis tendon.
e) Is inserted to the bases of the middle phalanges of the medial four fingers.

13. The radial artery:

a) Begins in the cubital fossa.
b) Runs undercover of the brachioradialis muscle.
c) The radial nerve lies on its medial side in the forearm.
d) Reaches the palm by passing between the two heads of the first dorsal interosseous muscle.
e) Shares in the formation of the deep palmar arch.

14. Injury of the upper limb nerves may lead to:

a) Claw hand in case of ulnar nerve injury.
b) Drop hand in case of radial nerve injury.
c) Winging of the scapula in case of long thoracic injury.
d) Erb paralyses in case of lower trunk injury.
e) Ape hand in case of median nerve injury.

15. The median nerve:

a) Arises from both the medial and lateral cords.
b) Its medial root crosses anterior to the axillary artery.
c) Passes lateral to the upper half of the brachial artery.
d) Lies on the anterior surface of the brachialis muscle.
e) Has no muscular branches in the arm.

16. The muscles deep to the femoral artery from medial to lateral are:

a) The iliacus.
b) The psoas major.
c) The pectineus.
d) The adductor longus.
e) The gracilis.

17. The contents of the femoral sheath are:

a) The femoral artery.
b) Femoral nerve.
c) The femoral vein.
d) The femoral branch of the genitofemoral nerve.
e) Areolar connective tissue.

18. The course of the common peroneal nerve:

a) Usually begins at the middle of the back of the thigh.
b) Passes on the medial side of the biceps femoris.
c) Leaves the fossa from its lateral angle.
d) Lies on the back of the head of the fibula.
e) Reaches the leg by passing on the medial side of the neck of the fibula.

19. Injury of the common peroneal nerve results in:

a) Foot drop.
b) Loss of sensation on the medial side of the big toe.
c) Loss of sensation on the lateral side of the little toe.
d) Week inversion of the foot.
e) Loss of eversion of the foot.

20. The adductor magnus muscle:

a) Arises partially from the ischial tuberosity.
b) Is inserted into the linea aspera.
c) The femoral vessels pass through one of its openings.
d) Is supplied by the obturator nerve only.
e) Its ischial part is inserted in the adductor tubercle.

21. The structures deep to the inferior extensor retinaculum are:

a) The extensor digitorum longus.
b) The extensor hallucis longus.
c) The anterior tibial artery.
d) The deep peroneal nerve.
e) Peroneus tertius.

22. The relations of the popliteal artery include:

a) The tibial nerve crosses it from lateral to medial.
b) The popliteus muscle is deep to it.
c) The popliteal vein crosses it from medial to lateral.
d) The capsule of the knee joint is deep to it.
e) It is separated from the back of the femur by fat.

23. The Peroneus longus muscle:

a) Arises from the lateral surface of the fibular.
b) Passes behind the lateral malleolus.
c) Passes in a groove in the navicular bone.
d) Is inserted into the medial cuneiform bone.
e) Is supplied by the superficial peroneal nerve.

24. The structures found in the second layer of the sole include:

a) The tendon of the flexor digitorum longus.
b) The tendon of the flexor hallucis longus.
c) Lumbrical muscles.
d) Interossei muscles.
e) Flexor digitorum accessorius.

25. The femoral artery in the femoral triangle:

a) The femoral vein separates it from the pectineus muscle.
b) The medial c n of the thigh crosses it from lateral to medial.
c) It is covered only by skin, superficial and deep fascia.
d) The profunda femoris artery arises from its medial side.
e) It leaves the triangle to the adductor canal.

26. The femoral nerve:

a) Arises from the lumbar plexus.
b) Its root value is 1, 2, 3, 4.
c) Supplies both the hip and knee joints.
d) Gives separate branches to each head of the quadriceps muscle.
e) Enters the thigh between the pectineus and adductor longus

27. The femoral sheath:

a) Formed anteriorly by the fascia transversalis.
b) Formed posteriorly by the fascia iliaca.
c) Its lateral compartment contains the femoral artery.
d) Its medial compartment contains the femoral vein.
e) Contains the femoral branch of the genitofemoral nerve.

28. The femoral ring:

a) Is blocked by the femoral septum.
b) Is bounded medially by the lacunar ligament.
c) Is bounded laterally by the femoral vein.
d) Is bounded anteriorly by the inguinal ligament.
e) Is bounded posteriorly by the iliopsoas tendon.

29. The superior gluteal nerve:

a) Is a branch of the sacral plexus.
b) Its root value is L4, 5 and S1.
c) Supplies the tensor fascia latae.
d) Supplies the gluteus maximus.
e) Supplies the gluteus medius.

30. Structures passing through the greater sciatic foramen are:

a) The tendon of the obturator internus.
b) The superior gluteal nerve.
c) The inferior gluteal vessels.
d) The posterior c n of the thigh.
e) The sciatic nerve.

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 PAGE OF THE BOOKLET.

LEQ 1. Describe the boundaries and contents of the popliteal fossa.
(15 minutes)

LEQ 2. Describe the boundaries and contents of the midcarpal space.
(15 minutes)

PART II: HISTOLOGY AND EMBRYOLOGY

SECTION A: MULTIPLE CHOICE QUESTIONS (MCQs) (20 minutes)
TYPE 3

INSTRUCTIONS

I) THERE ARE TEN (10) QUESTIONS IN THIS SECTION.

II) ANSWER ALL THE TEN (10) QUESTIONS.

III) THERE IS ONLY ONE WRONG STATEMENT AMONG THE FOUR RIGHT IN EACH QUESTION.

IV) CHOOSE THE WRONG STATEMENT.

1. Concerning cytology:

a) Plasma membrane range from 7, 5, to 10 nm in thickness.
b) The enzymes of electron transport system are located in the oxysomes of the mitochondrial cristae.
c) Ribosomes are synthesized within the nucleolus.
d) Smooth endoplasmic reticulum participates in the synthesis of proteins.
e) Lysosomes contain plenty of hydrolytic enzymes.

2. Regarding embryology:

a) Germ cells originate from mesoderm.
b) Ovulation takes place at the middle of the ovario-menstrual cycle.
c) There is no growth stage during the cleavage.
d) All three germ layers originate from the epiblast.
e) Syncytiotrophoblast of the chorionic villi produce chorionic gonadotropin.

3. In relation to epithelial tissue:

a) Epithelia receive their nutrition by diffusion.
b) All cells of simple epithelia are resting on the basal membrane.
c) Mammary gland release its secretion by the merocrine type.
d) Urinary bladder is lined by the transitional epithelium.
e) Epidermis is type of the stratified epithelium.

4. About connective tissue:

a) Fibrocytes have well developed RER.
b) Main components of the mast cells are heparin and histamine.
c) Elastic fibers anastomose among each other.
d) Sharpey’s fibers interconnect periosteum and outer circumferential lamellae of the bone.
e) Cartilage is avascular tissue.

5. Concerning muscle tissue:

a) Nuclei of the skeletal muscle fibers are located peripherally.
b) The triads of the skeletal muscle fibers are situated at the level of A – I junction.
c) Z-line is the site of attachment of myosin myofilaments.
d) Smooth muscle cells anastomose among each other forming syncytium.
e) Each skeletal muscle fiber is covered with endomysium.

6. Regarding nervous tissue:

a) Nissl granules are found in the perikaryon and dendrites of the nerve cells.
b) Node of Ranvier is not covered with myelin sheath.
c) Ependymal cells develop from the neural crest.
d) Meissner’s corpuscles are touch receptos.
e) Each skeletal muscle fiber receives axonal termination forming motor end plate.

7. In relation to integumentary system:

a) Sebaceous glands release their secretion by the holocrine type.
b) The vascular plexuses of the skin are located at the dermo-subcutaneous and reticulo-papillary junctions.
c) Outer and inner epithelial root sheaths are separated by the glassy membrane.
d) The myoepithelial cells help to deliver the secretion of the sweat glands.
e) The nail plate is resting on the nail bed.

8. About blood:

a) The main plasma proteins are albumin, globulins, prothrombin and fibrinogen.
b) There are about 4, 1-6 million per microlitre of RBC in men.
c) The monocytes do not have azurophilic granules.
d) The platelets originate from the megakaryocytes.
e) The first specific granules of the granulocytes appear at the stage of myelocyte.

9. Concerning hemo- and lymphopoietic organs:

a) The bone marrow produces all types of blood cells.
b) Hassal’s corpuscles are located within the medulla of thymus.
c) The splenic cords consist of erythrocytes and lymphocytes.
d) The sinuses of lymph nodes are formed by the network of macrophages, reticular cells and reticular fibers.
e) The pharyngeal tonsil has deep crypts.

10. Regarding lymphoid tissue:

a) Peyer’s patches of ileum occupy the lamina propria and submucosa.
b) The solitarian follicles of digestive tract are separated from the surrounding connective tissue by a thin capsule.
c) The palatine tonsils have 10 – 20 deep crypts lined with stratified squamous nonkeratinized epithelium.
d) The bronchiolar mucosa may contain lymphoid follicles.
e) The lamina propria and submucosa of appendix are heavily infiltrated with lymphoid follicles embedded into the diffuse lymphoid tissue.

SECTION B: MATCHING QUESTIONS (10 minutes)
TYPE 4

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

Box 1. Concerning cytology and embryology:

1. Peroxysomes A. Acrosomes.
2. Intercellular bridges B. Phagocytosis.
3. Golgi apparatus C. Epiblast.
4. Gastrulation D. Synthesis of lysosomes.
5. Hoffbauer cells E. Catalase.
F. Decidua basalis.
G. Desmosomes.
H. Gap junctions.

Box 2. Regarding tissues:

1. Columnar ciliated epithelium A. Phagocytosis.
2. Endothelium B. Muscle contraction.
3. Histiocytes C. Mesothelium.
4. Tropomyosin D. Stratified epithelium.
5. Ependymal glia E. Blood vessels.
F. Fourth ventricle of the brain.
G. Oviduct.
H. Microglia.

Box 3. In relation to the skin and its derivatives:

1. Cells of Langerhans A. Pressure receptors.
2. Eleidin B. Basal layer of epidermis.
3. Melanocytes C. Antigenes presenting.
4. Vater-pacinian corpuscles D. Hair bulb.
5. Stratum germinativum E. Hair cuticle.
F. Touch receptor.
G. Stratum lucidum.
H. Stratum granulosum.

Box 4. About bone marrow and blood:

1. Reticular cells A. Eosinophil’s granules.
2. Barr body B. Monocytes.
3. Crystalloid C. Plasma cells.
4. Basophils D. Stroma of bone marrow
5. B lymphocytes E. Histaminase.
F. Neutrophil.
H. Heparin.

Box 5. Concerning lymphoid organs:

1. PALS A. Follicles of the GIT.
2. High endothelial cells B. White pulp.
3. MALT C. T lymphocytes.
4. Malpigian bodies D. Thymus.
5. Accidental involution E. Billroth cords.
F. Subscapsular sinus.
G. Postcapillary venules.
H. Penicillar arterioles.

SECTION C: DESCRIPTION OF DIAGRAMS (20 Minutes)

INSTRUCTIONS:

I) THERE ARE FIVE (5) DIAGRAMS IN THIS SECTION.

II) WRITE THE NAMES OF THE DIAGRAMS (1 – 5) AND THEIR HISTOLOGICAL COMPONENTS (A – D) IN THE DIAGRAMS PROVIDED.

SECTION D: SHORT ANSWER QUESTION (SAQ) (10 Minutes)

INSTRUCTIONS:

I) THERE IS ONE (1) QUESTION IN THIS SECTION.

II) ANSWER THE QUESTION.

SAQ 1. Describe the morphological changes during various stages of erythropoiesis.
(10 minutes)

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