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NBME |! Anatomy |! Exam |! with |! precise |!
detailed |! solutions
at |! what |! vertebral |! level(s) |! should |! you |! perform |! a |! lumbar |! puncture |!? |! - |! Correct |! answer |! ✔L3/L4 |! or |! L4/L5; |! level |! of |! the |! iliac |! crests when |! doing |! a |! lumbar |! puncture, |! what |! does |! your |! needle |! pierce |! through |! - |! Correct |! answer |! ✔skin |! --> |! fascia |! --> |! supraspinous |! ligament |! --> |! interspinous |! ligament |! --> |! ligamentum |! flavum |! --> |! epidural |! space |! --> |! dura |! mater |! --> |! subarachnoid |! space What |! is |! a |! herniated |! disc? |! - |! Correct |! answer |! ✔nucleus |! pulposus |! through |! anulus |! fibrosus |! (nucleus |! pulposus |! is |! remnant |! of |! notochord) -usually |! herniates |! postero-laterally |! -compresses |! spinal |! nerve |! root most |! common |! levels |! of |! herniated |! disc |! - |! Correct |! answer |! ✔Lumbar |! Levels= |! L4/L5 |! or |! L5/S cervical |! regions= |! C5/C6 |! or |! C6/C herniated |! disk |! presentation |! - |! Correct |! answer |! ✔-individuals |! < -history |! of |! back |! pain |! that |! may |! radiate |! down |! to |! the |! lower |! limb -pain |! begins |! soon |! after |! patient |! lifted |! something |! heavy -herniated |! lumbar |! disc |! compresses |! the |! nerve |! root |! one |! number |! below |! (L4/L5 |! will |! compress |! the |! L5 |! root) -lower |! limb |! reflexes |! are |! decreased |! on |! the |! affected |! side |!
-patellar |! --> |! L2/L3 |! or |! L3/L4 |! herniation -achilles |! --> |! L5/S1 |! herniation what |! is |! kyphosis |!? who |! is |! it |! seen |! in? |! - |! Correct |! answer |! ✔-exaggeration |! of |! the |! thoracic |! curvature -may |! occur |! in |! the |! elderly |! as |! a |! result |! of |! osteoporosis |! or |! disk |! degeneration |! -osteoporosis= |! multiple |! compression |! fractures |! of |! the |! vertebral |! bodies what |! is |! lordosis? who |! is |! it |! seen |! in? |! - |! Correct |! answer |! ✔-exaggeration |! of |! the |! lumbar |! curvature |! that |! may |! be |! temporary -occurs |! during |! pregnancy, |! spondylolisthesis, |! or |! potbelly what |! is |! scoliosis? causes? |! - |! Correct |! answer |! ✔-lateral |! deviation/torsion |! of |! the |! spine -caused |! by |! poliomyelitis, |! leg |! length |! discrepancy, |! or |! hip |! disease what |! is |! the |! pars |! interarticularis |! - |! Correct |! answer |! ✔connects |! the |! superior |! facet |! and |! inferior |! facet what |! is |! spondylolysis? presentation? |! - |! Correct |! answer |! ✔-defect/stress |! fracture |! in |! the |! pars |! interarticularis |! -most |! common |! reason |! for |! lower |! back |! pain |! in |! adolescent |! athletes |! -usually |! at |! L
radicular |! lower |! back |! pain, |! saddle |! anesthesia, |! loss |! of |! DTR's, |! bowel/bladder |! issues |! - |! Correct |! answer |! ✔cauda |! equina |! syndrome, |! surgical |! emergency low |! back |! pain |! in |! adolescent |! with |! slip |! off |! or |! step |! off |! in |! spine |! examination |! - |! Correct |! answer |! ✔spondylolisthesis back |! pain |! in |! pregnancy |! - |! Correct |! answer |! ✔lumbar |! lordosis low |! back |! pain |! with |! loss |! of |! DTR's, |! loss |! of |! sensation |! in |! dermatome, |! + |! straight |! leg |! - |! Correct |! answer |! ✔disc |! herniation low |! back |! pain |! in |! IV |! drug |! user/immunocompromised, |! tenderness |! on |! palpation |! of |! spinous |! process, |! fever |! - |! Correct |! answer |! ✔vertebral |! osteomyelitis low |! back |! pain, |! hip/butt/thigh |! claudication, |! impotence |! and |! atrophy |! of |! lower |! extremities, |! weak |! femoral |! pulses, |! bruit |! heard |! over |! femoral |! area |! - |! Correct |! answer |! ✔lehriche |! syndrome, |! aorticoiliac |! PAD low |! back |! pain, |! male, |! 25-35 |! yo, |! morning |! stiffness |! and |! improves |! with |! activity, |! may |! have |! diarrhea |! or |! uveitis |! - |! Correct |! answer |! ✔ankylosing |! spondylitis, |! HLA |! B omohyoid |! innervation? insertion/origin? |! - |! Correct |! answer |! ✔-Scapula |! to |! the |! hyoid |! bone -Innervated |! by |! ansa |! cervicalis |! C1-C what |! is |! injured |! at |! the |! surgical |! neck |! of |! the |! humerus? |! - |! Correct |! answer |! ✔-axillary |! nerve |! and |! posterior |! humeral |! circumflex |! artery
what |! is |! injured |! in |! a |! midshaft |! humerus |! fracture? |! - |! Correct |! answer |! ✔-radial |! nerve |! and |! profunda |! brachii |! artery |! (deep |! brachial) -affect |! origin |! of |! brachialis |! muscle what |! is |! affected |! in |! a |! supracondylar |! humeral |! fracture? |! - |! Correct |! answer |! ✔-brachial |! artery |! and |! median |! nerve what |! is |! affected |! in |! a |! medial |! epicondyle |! fracture? |! - |! Correct |! answer |! ✔ulnar |! nerve humerus, |! radius, |! ulna |! bony |! landmarks |! - |! Correct |! answer |! ✔ what |! is |! the |! most |! common |! fracture |! of |! the |! forearm |! >50 |! yo |! - |! Correct |! answer |! ✔transverse |! fracture |! within |! the |! distal |! 2 |! cm |! of |! the |! radius what |! is |! a |! smith's |! fracture? |! - |! Correct |! answer |! ✔-results |! from |! a |! fall |! or |! a |! blow |! on |! the |! dorsal |! aspect |! of |! the |! flexed |! wrist |! -produces |! a |! ventral |! angulation |! of |! the |! wrist -the |! distal |! fragment |! of |! the |! radius |! is |! anteriorly |! displaced smiths |! fracture |! - |! Correct |! answer |! ✔ smiths |! fracture |! - |! Correct |! answer |! ✔ what |! is |! a |! colle's |! fracture? |! - |! Correct |! answer |! ✔-results |! from |! forced |! extension |! of |! the |! hand |! -usually |! as |! a |! result |! of |! trying |! to |! ease |! a |! fall |! by |! outstretching |! the |! upper |! limb -the |! distal |! fragment |! is |! displaced |! dorsally |! "dinner |! fork |! deformity"
-ex= |! when |! a |! baseball |! is |! mis-caught |! or |! a |! finger |! is |! jammed |! into |! a |! base |! pad rotator |! cuff |! muscles? |! - |! Correct |! answer |! ✔ what |! are |! the |! different |! shoulder |! abductor |! muscles? |! - |! Correct |! answer |! ✔0-15= |! supraspinatus |! (initiates |! abduction) 15-110= |! deltoid |! (abduction |! to |! the |! horizontal |! position) 110-180= |! trapezius |! and |! serratus |! anterior |! (raising |! the |! arm |! above |! the |! horizontal |! position |! requires |! scapular |! rotation) what |! are |! common |! causes |! of |! painful |! arm |! abduction? |! - |! Correct |! answer |! ✔-subacromial |! bursitis |! (inflammation |! of |! the |! subacromial |! bursa) |! --> |! often |! due |! to |! calcific |! supraspinatus |! tendinitis |! -inflammation |! or |! torn |! supraspinatus |! tendon triceps |! insertion? |! - |! Correct |! answer |! ✔olecranon what |! separates |! the |! olecranon |! from |! the |! skin? |! - |! Correct |! answer |! ✔-olecranon |! bursa torn |! supraspinatus |! - |! Correct |! answer |! ✔ what |! is |! "student's |! elbow" |! - |! Correct |! answer |! ✔-subcutaneous |! olecranon |! bursitis |! -caused |! by |! repeated |! excessive |! pressure/friction |! causing |! the |! bursa |! to |! become |! inflamed
cause |! of |! lateral |! epicondylitis? presentation? |! - |! Correct |! answer |! ✔-repeated |! forceful |! extension |! causes |! strain |! at |! the |! common |! extensor |! tendon |! and |! inflammation |! of |! the |! lateral |! epicondyle's |! periosteum -pain |! felt |! over |! the |! lateral |! epicondyle |! and |! radiates |! down |! the |! posterior |! aspect |! of |! the |! forearm |! -pain |! often |! felt |! when |! opening |! a |! door |! or |! lifting |! a |! glass origins |! of |! which |! muscles |! may |! be |! affected |! in |! lateral |! epicondylitis? |! - |! Correct |! answer |! ✔- extensor |! carpis |! radialis |! longus |! + |! brevis -extensor |! digitorum -extensor |! digit |! minimi -extensor |! carpi |! ulnaris what |! is |! medial |! epicondylitis? |! - |! Correct |! answer |! ✔-inflammation |! of |! the |! common |! flexor |! tendon |! at |! the |! medial |! epicondyle origins |! of |! which |! muscles |! may |! be |! affected |! in |! medial |! epicondylitis? |! - |! Correct |! answer |! ✔- pronator |! teres -flexor |! carpi |! radialis -palmaris |! longus -flexor |! carpi |! ulnaris upper |! extremity |! blood |! supply: |! - |! Correct |! answer |! ✔ scapula |! blood |! supply |! - |! Correct |! answer |! ✔1. |! subclavian |! --> |! thyrocervical |! trunk |! --> |! suprascapular |! + |! transverse |! cervical |! -transverse |! cervical |! --> |! dorsal |! scapular
DIP |! flexion |! tests |! which |! muscle? |! - |! Correct |! answer |! ✔flexor |! digitorum |! profundus Erb's |! palsy |! is |! an |! injury |! of? what |! are |! causes? |! - |! Correct |! answer |! ✔-injury |! of |! the |! upper |! trunk |! (C5-C6 |! roots) -due |! to |! excessive |! increase |! in |! the |! angle |! b/w |! the |! neck |! and |! the |! shoulder -may |! occur |! as |! birth |! injury |! from |! forceful |! pulling |! on |! infant's |! head |! during |! difficult |! delivery -falling |! injuries |! (motorcycle |! accident) which |! nerves |! are |! affected |! in |! Erb's |! palsy |! - |! Correct |! answer |! ✔-axillary -suprascapular |! -musculocutaneous how |! does |! a |! patient |! present |! with |! erb's |! palsy? |! - |! Correct |! answer |! ✔-arm |! is |! adducted -arm |! is |! medially |! rotated |! -elbow |! is |! extended |! -loss |! of |! sensation |! in |! the |! lateral |! aspect |! of |! the |! upper |! limb Klumpke's |! palsy |! is |! an |! injury |! of? what |! are |! causes? |! - |! Correct |! answer |! ✔-injury |! of |! the |! lower |! trunk |! (C8-T1 |! roots) -may |! occur |! when |! the |! upper |! limb |! is |! suddenly |! pulled |! superiorly |! -grabbing |! support |! during |! falling |! from |! heigh -birth |! injury -thoracic |! outlet |! syndrome
which |! nerves |! are |! affected |! in |! Klumpke's |! palsy? |! - |! Correct |! answer |! ✔-ulnar |! and |! median |! nerve how |! may |! Klumpke's |! present? |! - |! Correct |! answer |! ✔-total |! claw |! hand |! (all |! intrinsic |! muscles |! of |! the |! hand |! are |! affected) -loss |! of |! sensation |! in |! the |! medial |! aspect |! of |! he |! upper |! limb |! and |! medial |! 1.5 |! fingers -may |! have |! Horner's |! syndrome causes |! of |! musculocutaneous |! n. |! injuries? presentation? |! - |! Correct |! answer |! ✔-lesions |! to |! the |! lateral |! cord |! -weakened |! flexion |! at |! the |! elbow |! (biceps |! and |! brachialis) -weakened |! supination |! of |! the |! forearm |! (biceps) |! -may |! have |! sensory |! loss |! over |! the |! lateral |! aspect |! of |! the |! forearm sensory |! supply |! of |! the |! hand |! - |! Correct |! answer |! ✔-the |! yellow |! circle |! (b/w |! thumb |! and |! index |! finger) |! is |! an |! area |! supplied |! only |! by |! hte |! superficial |! radial |! n another |! image |! of |! the |! sensory |! innervation |! of |! the |! hands |! - |! Correct |! answer |! ✔click |! on |! the |! image |! for |! better |! view what |! artery |! is |! used |! for |! cardiac |! catheterization? |! - |! Correct |! answer |! ✔femoral |! artery what |! is |! the |! pathway |! of |! the |! cardiac |! catheter? |! - |! Correct |! answer |! ✔femoral |! artery |! --> |! external |! iliac |! --> |! common |! iliac |! --> |! aorta |! --> |! left |! ventricle femoral |! neck |! fractures |! are |! commonly |! seen |! in? |! - |! Correct |! answer |! ✔elderly |! women |! with |! osteoporosis
medially |! rotated causes |! of |! superior |! gluteal |! n |! injury? |! - |! Correct |! answer |! ✔-surgery -posterior |! hip |! dislocation -poliomyelitis causes |! of |! inferior |! gluteal |! n |! injury? |! - |! Correct |! answer |! ✔-surgery -posterior |! hip |! dislocation causes |! of |! obturator |! n |! injury? presentation? |! - |! Correct |! answer |! ✔-anterior |! hip |! dislocation |! -radical |! retropubic |! prostatectomy -difficulty |! adducting |! the |! thigh |! (crossing |! legs |! while |! sitting) -decreased |! sensation |! over |! the |! upper |! medial |! thigh hamstring |! avulsion |! fracture |! affects |! what |! bony |! landmark? which |! muscles |! are |! involved? |! - |! Correct |! answer |! ✔-ischial |! tuberosity |! -long |! head |! biceps |! femoris -semitendinosus -semimembranosus |! -hamstring |! part |! of |! adductor |! magnus what |! nerve |! supplies |! the |! hamstring |! muscles? |! - |! Correct |! answer |! ✔tibial |! n
which |! nerve |! supplies |! the |! short |! head |! of |! biceps |! femoris? |! - |! Correct |! answer |! ✔common |! fibular |! nerve structures |! under |! the |! inguinal |! ligament |! form |! lateral |! to |! medial: |! - |! Correct |! answer |! ✔-lateral |! femoral |! cutaneous |! nerve -iliopsoas -femoral |! nerve -femoral |! artery -femoral |! vein -femoral |! canal |! (deep |! inguinal |! nodes) -lacunar |! ligament which |! structures |! are |! in |! the |! femoral |! sheath? |! - |! Correct |! answer |! ✔femoral |! artery, |! vein, |! lymphatics femoral |! hernia |! location? (what |! structures |! does |! it |! protrude |! through? |! where |! do |! you |! see |! it?) |! - |! Correct |! answer |! ✔- passes |! through |! the |! femoral |! ring |! into |! the |! femoral |! canal |! -found |! below |! the |! inguinal |! ligament |! -upper |! thigh |! inferior |! and |! lateral |! to |! the |! pubic |! tubercle |! -the |! herniated |! sac |! may |! protrude |! through |! the |! saphenous |! hiatus |! into |! the |! superficial |! fascia femoral |! hernias |! are |! more |! common |! in? |! - |! Correct |! answer |! ✔women why |! are |! femoral |! hernias |! concerning? |! - |! Correct |! answer |! ✔herniated |! sac |! is |! more |! likely |! to |! become |! strangulated
where |! is |! the |! suprapatellar |! bursa |! located? |! - |! Correct |! answer |! ✔superior |! extension |! of |! synovial |! cavity |! b/w |! the |! distal |! end |! of |! the |! femur |! and |! quadriceps |! muscle |! tendon where |! do |! you |! usually |! give |! intra-articular |! injections? |! - |! Correct |! answer |! ✔suprapatellar |! bursa what |! is |! the |! most |! common |! ankle |! injury? |! - |! Correct |! answer |! ✔sprain an |! ankle |! sprain |! injury |! is |! more |! commonly |! inversion |! or |! eversion? |! - |! Correct |! answer |! ✔inversion |! --> |! involves |! twisting |! of |! the |! weight-bearing |! plantarflexed |! foot why |! are |! inversion |! injuries |! more |! common |! - |! Correct |! answer |! ✔the |! lateral |! ligament |! is |! much |! weaker |! than |! the |! medial |! ligament which |! ankle |! ligament |! is |! most |! commonly |! sprained? |! - |! Correct |! answer |! ✔anterior |! talofibular |! ligament what |! may |! also |! be |! injured |! in |! severe |! lateral |! ankle |! sprains? |! - |! Correct |! answer |! ✔lateral |! malleolus |! of |! the |! fibular |! may |! be |! fractured how |! does |! a |! Potts |! fracture |! occur? what |! is |! injured? |! - |! Correct |! answer |! ✔-forced |! eversion |! of |! the |! foot -the |! deltoid |! ligament |! is |! very |! strong |! and |! usually |! doesn't |! tear -instead, |! the |! deltoid |! ligament |! causes |! medial |! malleolus |! avulsion |! -fracture |! of |! lateral |! malleolus |! -see |! fibula |! fracture |! at |! a |! higher |! level |! -talus |! dislocates |! laterally -torn |! anterior |! tibiofibular |! ligament
avulsion |! or |! rupture |! of |! the |! calcaneal |! tendon |! presentation? |! - |! Correct |! answer |! ✔the |! triceps |! surae |! muscles |! (gastrocnemius |! and |! soleus) |! are |! unable |! to |! plantar |! flex calcaneal |! spur |! causes? presentation? |! - |! Correct |! answer |! ✔-plantar |! fasciitis -pain |! on |! the |! plantar |! surface |! of |! the |! foot/heel -see |! point |! tenderness |! at |! the |! proximal |! attachment |! of |! the |! plantar |! aponeurosis |! to |! the |! medial |! tubercle |! of |! the |! calcaneus popliteal |! fossa |! contains |! what |! structures |! from |! superficial |! to |! deep? |! - |! Correct |! answer |! ✔tibial |! nerve, |! popliteal |! vein, |! popliteal |! artery what |! are |! the |! terminal |! branches |! of |! the |! tibial |! nerve? |! - |! Correct |! answer |! ✔medial |! plantar |! nerve |! and |! lateral |! plantar |! nerve what |! does |! the |! medial |! plantar |! nerve |! supply? |! - |! Correct |! answer |! ✔abductor |! hallicus flexor |! hallucis |! brevis flexor |! digitorum |! brevis 1st |! lumbrical |! muscles skin |! of |! medial |! 3.5 |! digits what |! does |! the |! lateral |! plantar |! nerve |! supply? |! - |! Correct |! answer |! ✔all |! intrinsic |! plantar |! muscles |! that |! are |! not |! innervated |! by |! the |! medial |! plantar |! nerve skin |! of |! the |! lateral |! 1.5 |! digits
which |! intercostal |! structures |! are |! most |! vulnerable |! to |! injury? |! - |! Correct |! answer |! ✔intercostal |! nerve |! and |! posterior |! intercostal |! artery |! (not |! covered |! by |! ribs) if |! the |! right |! phrenic |! nerve |! is |! injured, |! how |! does |! that |! present? |! - |! Correct |! answer |! ✔-paralysis |! of |! the |! right |! half |! of |! the |! diaphragm -during |! inspiration, |! the |! left |! side |! of |! the |! diaphragm |! contracts |! down |! causing |! increased |! pressure |! on |! the |! right |! side |! causing |! the |! right |! diaphragm |! to |! be |! pushed |! superiorly phrenic |! nerve |! course: |! - |! Correct |! answer |! ✔-arises |! from |! C3-C5 |! nerves -passes |! anterior |! to |! the |! anterior |! scalene |! muscle |! -runs |! anterior |! to |! the |! root |! of |! the |! lung |! (vagus |! nerve |! runs |! posterior |! to |! the |! root |! of |! the |! lung phrenic |! nerve |! fx |! - |! Correct |! answer |! ✔sensory: |! -fibrous |! pericardium -mediastinal |! and |! diaphragmatic |! pleura -diaphragm |! central |! tendon |! motor: -diaphragm causes |! of |! diaphragmatic |! ruptures? |! - |! Correct |! answer |! ✔-blunt |! or |! penetrating |! trauma -blunt |! trauma |! is |! usually |! due |! to |! MVA blunt |! diaphragmatic |! rupture |! presentation |! - |! Correct |! answer |! ✔-left |! sided -tears |! usually |! occur |! at |! the |! posterolateral |! aspect |! of |! the |! diaphragm |! -bowel |! sounds |! on |! auscultation |! of |! the |! lung |! fields
what |! passes |! through |! the |! different |! diaphragmatic |! hiatuses |!? |! - |! Correct |! answer |! ✔"I |! 8 |! (ate) |! 10 |! Eggs |! At |! 12" T8= |! caval |! hiatus -IVC, |! right |! phrenic |! nerve T10= |! esophageal |! hiatus -esophagus, |! vagus |! nerves, |! esophageal |! branches |! of |! the |! left |! gastric |! vessels T12= |! aortic |! hiatus -descending |! aorta, |! thoracic |! duct, |! azygos |! vein |! (red |! white |! blue) on |! Xray, |! what |! forms |! the |! cardiac |! shadow's: right |! border? left |! border? |! - |! Correct |! answer |! ✔right |! border= |! SVC |! + |! right |! atrium left |! border= |! aortic |! arch, |! pulmonary |! trunk, |! left |! auricle, |! left |! ventricle where |! is |! the |! SA |! node |! located? |! - |! Correct |! answer |! ✔-upper |! part |! of |! the |! sulcus |! terminalis |! near |! the |! opening |! of |! the |! SVC where |! is |! the |! AV |! node |! located? |! - |! Correct |! answer |! ✔-lower |! part |! of |! the |! atrial |! septum |! near |! the |! coronary |! sinus where |! is |! the |! moderator |! band |! located? |! - |! Correct |! answer |! ✔right |! ventricle
