NOTES ON MULTIPLE CHOICE QUESTIONS

IN ANATOMY BY ROBERT WHITAKER

SAMPLE OF BOF (BEST OF FIVE)

The characteristics of a hinge joint are that

A It allows flexion, extension and circumduction

B It has strong collateral ligaments

C It is the only joint that disobeys Hilton’s Law for innervation

D It is only found in the hand

E It has the same movements as a condyloid joint

Chances of guessing correct answer is 20% (B is correct)

SAMPLE OF MTF (MULTIPLE TRUE/FALSE)

Muscles arising from common extensor origin

A Extensor pollicis longus

B Brachioradialis

C Extensor digiti minimi

D Extensor carpi radialis longus

E Extensor carpi radialis brevis

Chances of guessing correct answer is 50% for each stem (A-F, B-F, C-T, D-F, E-T)

SAMPLE OF EM (EXTENDED MATCHING)

THEME: NUMBERS OF VERTEBRAE

A 2 B 4

C 5 D 6

E 7 F 8

G 10 H 12

I 14

For each of the vertebral regions listed below, choose the single most likely option from the list of numbers above. Each option can be used once, more than once or not at all.

1 Cervical

2 Thoracic

3 Lumbar

4 Sacral

Chances of guessing correct answer is approximately 10% (1-E, 2-H, 3-C, 4-C)

The scaphoid bone

A. Is a tarsal bone in the proximal row F

B. Lies on the medial side of the hand F

C. Has a blood supply that runs predominantly distal to proximal T

D. Articulates with the ulna at the wrist joint F

E. Has a blood supply that is predominantly from the ulnar artery F

TYPICAL TOPICS FOR MCQs ARRANGED REGIONALLY

ABDOMEN

· Transpyloric plane

· Vertebral levels

· Palpability of Spleen and other organs

· Pathways for referred pain

· Surface markings (McBurneys, mid-inguinal, etc)

· Size of liver and landmarks of liver

· Lesser sac and Pringle’s manoeuvre

· Blood supply of intestine, particularly stomach

· Portal system, oesophageal varices, portosystemic anastomoses

· Gall bladder, particularly its blood supply

· Retroperitoneal V on mesentery

· Diaphragm and its openings

· Descent of the testis

· Haemorrhoids and anal canal

· Inguinal canal and herniae

· Aorta, vena cava and posterior abdominal wall

ARM

· T1 root compression, cervical rib, first rib relations

· Dermatomes

· Upper and lower brachial plexus lesions, Erb’s palsy and claw hand

· Cubital fossa, supracondylar fractures,

· Median nerve and testing for damage

· Brachial plexus in general

· Dupuytren’s contracture and carpal tunnel syndrome, flexor retinaculum

· Structures across wrist

· Dislocation of shoulder and damage to axillary nerve

· Abduction of shoulder

· Snuff box

· Small muscles of hand

· Scaphoid

· Avascular necrosis – examples - fractured neck of femur

· Fractured humerus and nerve injury

· Palmar arterial arches

· Sensory and motor testing in hand

LEG

· Knee injury – cruciates and unhappy triad

· Knee – action of hamstrings on it

· Bursae around knee

· Saphenous veins and nerve

· Reflexes and dermatomes

· Femoral triangle

· Popliteal fossa and branches of popliteal artery

· Common fibular nerve and foot drop

· Ankle – ligaments, relations, tendons, inversion and eversion

· Lumbar and sacral plexuses

· Femoral nerve, sheath and canal

· Compartment syndrome

THORAX

· Surface markings of lungs, heart, pleura

· Bronchial tree

· Heart – sounds, chambers, blood supply, anomalous and normal fetal development

· Heart – oblique and transverse sinuses

· Sympathetic chain

· Surface anatomy of lung impressions

· Vertebral levels

· Recurrent laryngeal nerves

· Mediastina

· Oesophagus

· Phrenic and vagus nerves

VERTEBRAL COLUMN

· Characteristics of vertebrae at various levels

· Movements at different levels

· Disc lesions and nerve damage

· Levels for end of cord and dural sac

· Lumbar puncture

HEAD AND NECK

· Extradural, subarachnoid and subdural haemorrhages

· Middle meningeal artery

· Nerve damage with raised intracranial pressure

· Exit sites for cranial nerves

· Function of cranial nerves

· Nose, nasopharynx and Eustachian tube and tonsils

· Bell’s palsy versus stroke

· Sensory distribution of trigeminal nerve

· Maxillary sinus and Little’s area

· Muscles of mastication

· Contents of skull foramina

· CSF and main ventricles

· Venous sinuses

· Parasympathetic ganglia

· Posterior triangle of neck and spinal root of accessory nerve

· Vertebral levels in neck

· Surface anatomy of jugular veins

· Larynx and its relations – tracheostomy, cricothyroidotomy

· Larynx – cord movements and muscles. Sensory innervation

· Thyroid gland and its development. Nerve damage at thyroid surgery

· Parathyroid glands and risks at thyroid surgery

· Branchial arches and associated nerves

· Eye movements and lesions including Horner’s and III nerve

· Pupil constriction and dilatation

· Visual pathways, “light” and “near” reflexes