FMGE 2017 — Anatomy

Q: Cords of Billroth in spleen are found in

Red pulp. ***Correct: Red pulp*** - The **cords of Billroth** (or splenic cords) are a distinctive histological feature of the **red pulp** of the spleen. - These cords consist of a meshwork of reticular cells and reticular fibers, packed with macrophages, lymphocytes, plasma cells, and abundant red blood cells. *Incorrect: White pulp* - The **white pulp** is primarily involved in immune functions, containing lymphoid follicles rich in lymphocytes. - It is organized around central arterioles and does not contain the cords of Billroth. *Incorrect: Trabecular zone* - The **trabecular zone** consists of connective tissue septa that extend inward from the splenic capsule, carrying blood vessels and nerves. - It provides structural support to the spleen but is not where the cords of Billroth are located. *Incorrect: Mantle zone* - The **mantle zone** is a region within the **white pulp**, surrounding the germinal centers of lymphoid follicles. - It is composed mainly of naive B lymphocytes and is distinct from the cords of Billroth. [Practice more Anatomy PYQs on OnCourse]

Q: NOT a content of carpal tunnel:-

Ulnar nerve. ***Ulnar nerve*** - The **ulnar nerve** passes superficial to the **flexor retinaculum**, meaning it is not a direct content of the carpal tunnel [1]. - Instead, it travels through a separate space known as **Guyon's canal**, alongside the ulnar artery [1]. *Median nerve* - The **median nerve** is a primary content of the carpal tunnel and is susceptible to compression within this space, leading to carpal tunnel syndrome [1]. - It provides sensory innervation to the lateral palm and digits, and motor innervation to certain thenar muscles [1]. *Flexor digitorum profundus* - The tendons of the **flexor digitorum profundus** muscles (four of them) pass through the carpal tunnel to insert onto the distal phalanges. - These tendons are responsible for **flexion of the distal interphalangeal (DIP) joints** of the medial four fingers. *Flexor digitorum superficialis* - The tendons of the **flexor digitorum superficialis** muscles (four of them) also pass through the carpal tunnel. - They are responsible for **flexion of the proximal interphalangeal (PIP) joints** of the medial four fingers. [Practice more Anatomy PYQs on OnCourse]

Q: Which of the following is TRUE about bronchopulmonary segments?

Pulmonary veins are intersegmental. Detailed knowledge of lung anatomy is essential for thoracic surgery. ***Pulmonary veins are intersegmental*** - The **pulmonary veins** run in the connective tissue septa **between** the bronchopulmonary segments, making them **intersegmental** [1]. - This anatomical arrangement allows surgeons to ligate the veins without affecting adjacent segments during a segmentectomy. *Spherical in shape* - Bronchopulmonary segments are typically **pyramid-shaped** or cone-shaped, with their apices directed towards the hilum [1]. - Their irregular, wedge-like structure allows them to fit together within the lung. *Artery is intersegmental* - The **bronchial arteries** and **pulmonary arteries** are **intrasegmental**, meaning they run **within** the bronchopulmonary segment alongside the bronchi. - Each segment has its own arterial supply, allowing for independent blood flow. *Non resectable* - Bronchopulmonary segments are considered **functionally and surgically independent units**, making them **resectable** [1]. - This allows for the removal of diseased segments while preserving healthy lung tissue, such as in cases of **lung cancer** or localized infection. [Practice more Anatomy PYQs on OnCourse]

Q: Left anterior descending artery is a direct branch of

Left coronary artery. ***Left coronary artery*** - The left coronary artery (LCA) is a major coronary artery that arises from the **aorta** and quickly branches into two main arteries: the **left anterior descending (LAD) artery** [1] and the circumflex artery. - The LAD artery, also known as the **"widowmaker"**, supplies oxygenated blood to the **anterior wall of the left ventricle** and the interventricular septum, making it crucial for heart function. *Right coronary artery* - The **right coronary artery (RCA)** typically supplies the **right atrium**, most of the **right ventricle**, and the inferior wall of the left ventricle, which are distinct areas from the LAD's supply. - The RCA originates from the **right sinus of Valsalva** and travels in the atrioventricular groove, while the LAD originates from the left main coronary artery [1]. *Circumflex artery* - The circumflex artery is another main branch of the **left coronary artery**, typically supplying the **lateral and posterior walls of the left ventricle** and the left atrium. - While it branches from the same parent vessel as the LAD, it is a direct branch itself, not the origin of the LAD [1]. *Ascending aorta* - The ascending aorta is the initial part of the aorta that originates from the **left ventricle** and gives rise to the **coronary arteries** (both left and right coronary arteries). - It is the source from which the **left coronary artery** (and thus the LAD indirectly) originates, but it is not a direct branch itself. [Practice more Anatomy PYQs on OnCourse]

Q: Cutaneous supply over the parotid gland is by:

Greater auricular nerve. ***Greater auricular nerve*** - The **greater auricular nerve**, a branch of the cervical plexus (C2-C3), is the **primary cutaneous nerve** supplying sensation to the skin over the parotid gland and the angle of the mandible. - It ascends from behind the sternocleidomastoid muscle and provides the main sensory innervation to the parotid region, making it the most important nerve for this area. *Auriculotemporal nerve* - The **auriculotemporal nerve** (branch of mandibular division of trigeminal nerve) supplies sensory innervation to the skin of the temporal region, the external auditory meatus, and the tympanic membrane. - While it provides some cutaneous supply to the upper/posterior part of the parotid region, the **greater auricular nerve is the primary cutaneous nerve** over the parotid gland proper. - It also carries postganglionic parasympathetic fibers (from otic ganglion) to the parotid gland for secretomotor function. *Greater occipital nerve* - The **greater occipital nerve** is responsible for cutaneous sensation to the posterior scalp, up to the vertex of the head. - It arises from the dorsal ramus of C2 and has no role in the cutaneous supply over the parotid gland. *Facial nerve* - The **facial nerve (CN VII)** is primarily a motor nerve that controls the muscles of facial expression. - While it passes through the parotid gland and divides within it, it does not provide cutaneous sensory innervation to the skin overlying the gland. [Practice more Anatomy PYQs on OnCourse]

10 Previous Year Questions with Answers & Explanations

Questions

All Subjects Anatomy (10)Biochemistry (4)Community Medicine (2)Dental (1)Dermatology (1)Internal Medicine (14)Microbiology (2)Obstetrics and Gynecology (3)Ophthalmology (2)Orthopaedics (2)Pathology (5)Pediatrics (2)Pharmacology (16)Physiology (5)Psychiatry (6)Radiology (1)Surgery (2)

Cords of Billroth in spleen are found in

NOT a content of carpal tunnel:-

Which of the following is TRUE about bronchopulmonary segments?

Left anterior descending artery is a direct branch of

Cutaneous supply over the parotid gland is by:

The cranial nerve passing through cavernous sinus is

NOT a content of superior mediastinum

Which of the following structures passes through Guyon's canal?

Tendons in the 2nd compartment of wrist?

Q10

In pediatric assessment, a cephalic index of 75-80 is classified as:

FMGE 2017 - Anatomy FMGE Practice Questions and MCQs

Question 1: Cords of Billroth in spleen are found in

A. White pulp
B. Red pulp (Correct Answer)
C. Trabecular zone
D. Mantle zone

Explanation: ***Correct: Red pulp*** - The **cords of Billroth** (or splenic cords) are a distinctive histological feature of the **red pulp** of the spleen. - These cords consist of a meshwork of reticular cells and reticular fibers, packed with macrophages, lymphocytes, plasma cells, and abundant red blood cells. *Incorrect: White pulp* - The **white pulp** is primarily involved in immune functions, containing lymphoid follicles rich in lymphocytes. - It is organized around central arterioles and does not contain the cords of Billroth. *Incorrect: Trabecular zone* - The **trabecular zone** consists of connective tissue septa that extend inward from the splenic capsule, carrying blood vessels and nerves. - It provides structural support to the spleen but is not where the cords of Billroth are located. *Incorrect: Mantle zone* - The **mantle zone** is a region within the **white pulp**, surrounding the germinal centers of lymphoid follicles. - It is composed mainly of naive B lymphocytes and is distinct from the cords of Billroth.

Question 2: NOT a content of carpal tunnel:-

A. Median nerve
B. Flexor digitorum profundus
C. Flexor digitorum superficialis
D. Ulnar nerve (Correct Answer)

Explanation: ***Ulnar nerve*** - The **ulnar nerve** passes superficial to the **flexor retinaculum**, meaning it is not a direct content of the carpal tunnel [1]. - Instead, it travels through a separate space known as **Guyon's canal**, alongside the ulnar artery [1]. *Median nerve* - The **median nerve** is a primary content of the carpal tunnel and is susceptible to compression within this space, leading to carpal tunnel syndrome [1]. - It provides sensory innervation to the lateral palm and digits, and motor innervation to certain thenar muscles [1]. *Flexor digitorum profundus* - The tendons of the **flexor digitorum profundus** muscles (four of them) pass through the carpal tunnel to insert onto the distal phalanges. - These tendons are responsible for **flexion of the distal interphalangeal (DIP) joints** of the medial four fingers. *Flexor digitorum superficialis* - The tendons of the **flexor digitorum superficialis** muscles (four of them) also pass through the carpal tunnel. - They are responsible for **flexion of the proximal interphalangeal (PIP) joints** of the medial four fingers.

Question 3: Which of the following is TRUE about bronchopulmonary segments?

A. Spherical in shape
B. Artery is intersegmental
C. Pulmonary veins are intersegmental (Correct Answer)
D. Non resectable

Explanation: Detailed knowledge of lung anatomy is essential for thoracic surgery. ***Pulmonary veins are intersegmental*** - The **pulmonary veins** run in the connective tissue septa **between** the bronchopulmonary segments, making them **intersegmental** [1]. - This anatomical arrangement allows surgeons to ligate the veins without affecting adjacent segments during a segmentectomy. *Spherical in shape* - Bronchopulmonary segments are typically **pyramid-shaped** or cone-shaped, with their apices directed towards the hilum [1]. - Their irregular, wedge-like structure allows them to fit together within the lung. *Artery is intersegmental* - The **bronchial arteries** and **pulmonary arteries** are **intrasegmental**, meaning they run **within** the bronchopulmonary segment alongside the bronchi. - Each segment has its own arterial supply, allowing for independent blood flow. *Non resectable* - Bronchopulmonary segments are considered **functionally and surgically independent units**, making them **resectable** [1]. - This allows for the removal of diseased segments while preserving healthy lung tissue, such as in cases of **lung cancer** or localized infection.

Question 4: Left anterior descending artery is a direct branch of

A. Right coronary artery
B. Circumflex artery
C. Left coronary artery (Correct Answer)
D. Ascending aorta

Explanation: ***Left coronary artery*** - The left coronary artery (LCA) is a major coronary artery that arises from the **aorta** and quickly branches into two main arteries: the **left anterior descending (LAD) artery** [1] and the circumflex artery. - The LAD artery, also known as the **"widowmaker"**, supplies oxygenated blood to the **anterior wall of the left ventricle** and the interventricular septum, making it crucial for heart function. *Right coronary artery* - The **right coronary artery (RCA)** typically supplies the **right atrium**, most of the **right ventricle**, and the inferior wall of the left ventricle, which are distinct areas from the LAD's supply. - The RCA originates from the **right sinus of Valsalva** and travels in the atrioventricular groove, while the LAD originates from the left main coronary artery [1]. *Circumflex artery* - The circumflex artery is another main branch of the **left coronary artery**, typically supplying the **lateral and posterior walls of the left ventricle** and the left atrium. - While it branches from the same parent vessel as the LAD, it is a direct branch itself, not the origin of the LAD [1]. *Ascending aorta* - The ascending aorta is the initial part of the aorta that originates from the **left ventricle** and gives rise to the **coronary arteries** (both left and right coronary arteries). - It is the source from which the **left coronary artery** (and thus the LAD indirectly) originates, but it is not a direct branch itself.

Question 5: Cutaneous supply over the parotid gland is by:

A. Auriculotemporal nerve
B. Greater occipital nerve
C. Facial nerve
D. Greater auricular nerve (Correct Answer)

Explanation: ***Greater auricular nerve*** - The **greater auricular nerve**, a branch of the cervical plexus (C2-C3), is the **primary cutaneous nerve** supplying sensation to the skin over the parotid gland and the angle of the mandible. - It ascends from behind the sternocleidomastoid muscle and provides the main sensory innervation to the parotid region, making it the most important nerve for this area. *Auriculotemporal nerve* - The **auriculotemporal nerve** (branch of mandibular division of trigeminal nerve) supplies sensory innervation to the skin of the temporal region, the external auditory meatus, and the tympanic membrane. - While it provides some cutaneous supply to the upper/posterior part of the parotid region, the **greater auricular nerve is the primary cutaneous nerve** over the parotid gland proper. - It also carries postganglionic parasympathetic fibers (from otic ganglion) to the parotid gland for secretomotor function. *Greater occipital nerve* - The **greater occipital nerve** is responsible for cutaneous sensation to the posterior scalp, up to the vertex of the head. - It arises from the dorsal ramus of C2 and has no role in the cutaneous supply over the parotid gland. *Facial nerve* - The **facial nerve (CN VII)** is primarily a motor nerve that controls the muscles of facial expression. - While it passes through the parotid gland and divides within it, it does not provide cutaneous sensory innervation to the skin overlying the gland.

Question 6: The cranial nerve passing through cavernous sinus is

A. Olfactory
B. Abducens (Correct Answer)
C. Facial
D. Optic

Explanation: ***Abducens*** - The **abducens nerve (CN VI)** is the only cranial nerve that travels **through the substance of the cavernous sinus** itself, running alongside the internal carotid artery. - This unique intracavernous location makes it the most vulnerable cranial nerve to injury from cavernous sinus pathology (thrombosis, tumors, aneurysms). - Other nerves (CN III, IV, V1, V2) run in the **lateral wall** of the sinus, not through it. *Olfactory* - The **olfactory nerve (CN I)** runs from the nasal cavity through the cribriform plate to the olfactory bulb. - It does not traverse the cavernous sinus. *Facial* - The **facial nerve (CN VII)** exits the skull via the stylomastoid foramen and has a complex course through the temporal bone. - It does not pass through the cavernous sinus. *Optic* - The **optic nerve (CN II)** exits the orbit through the optic canal to reach the optic chiasm. - It does not travel through the cavernous sinus, though it is in close anatomical proximity to structures anterior to it.

Question 7: NOT a content of superior mediastinum

A. Arch of aorta
B. Thymus
C. Pulmonary trunk
D. Left superior intercostal artery (Correct Answer)

Explanation: ***Left superior intercostal artery*** - The **left superior intercostal artery** arises from the **costocervical trunk** (a branch of the subclavian artery) and is NOT considered a primary content of the superior mediastinum. - It descends to supply the **first and second (sometimes third) intercostal spaces** on the left side. - While it may pass near the superior mediastinum, it is anatomically classified with the **posterior mediastinum** structures. *Arch of aorta* - The **arch of the aorta** is a major structure within the **superior mediastinum** [1]. - It gives off three major branches: brachiocephalic trunk, left common carotid artery, and left subclavian artery [2]. - It extends from approximately the level of the **second costal cartilage** to the **lower border of T4 vertebra**. *Thymus* - The **thymus gland** is located in the **anterior mediastinum**, NOT the superior mediastinum [1]. - It lies posterior to the sternum and anterior to the pericardium and great vessels. - However, it may extend superiorly into the lower part of the neck, and in some classifications, its superior portion overlaps with the superior mediastinum [1]. *Pulmonary trunk* - The **pulmonary trunk** is located in the **middle mediastinum** within the pericardial sac, NOT the superior mediastinum [1]. - It originates from the **right ventricle** at a level below the superior mediastinum (which extends only to the sternal angle/T4-5 level). - It carries deoxygenated blood from the right ventricle to the lungs.

Question 8: Which of the following structures passes through Guyon's canal?

A. Ulnar nerve (Correct Answer)
B. Flexor carpi radialis
C. Radial nerve
D. Median nerve

Explanation: ### Ulnar nerve - The **ulnar nerve** passes through Guyon's canal, along with the ulnar artery, making it susceptible to compression here [1]. - Compression of the ulnar nerve in Guyon's canal can lead to motor and sensory deficits in its distribution, known as **ulnar tunnel syndrome** [1]. ### Flexor carpi radialis - The **flexor carpi radialis tendon** passes through a separate compartment in the carpal tunnel, distinct from Guyon's canal. - Its primary function is wrist flexion and radial deviation, and it is not associated with Guyon's canal. ### Radial nerve - The **radial nerve** courses along the lateral aspect of the forearm and hand and does not pass through Guyon's canal. - Its injury typically manifests as **wrist drop** and sensory loss over the dorsum of the hand. ### Median nerve - The **median nerve** passes through the carpal tunnel, which is medial to Guyon's canal in the wrist [1]. - Entrapment of the median nerve in the carpal tunnel causes **carpal tunnel syndrome**, characterized by symptoms in the thumb, index, middle, and radial half of the ring finger [1].

Question 9: Tendons in the 2nd compartment of wrist?

A. Extensor pollicis longus
B. Extensor pollicis brevis
C. Abductor pollicis longus
D. Extensor carpi radialis brevis and longus (Correct Answer)

Explanation: ***Extensor carpi radialis brevis and longus*** - The **second dorsal compartment** of the wrist houses the tendons of the **extensor carpi radialis longus (ECRL)** and **extensor carpi radialis brevis (ECRB)** muscles [1]. - These muscles are primarily responsible for **wrist extension** and **radial deviation** of the hand [1]. *Extensor pollicis longus* - The **extensor pollicis longus (EPL)** tendon is located in the **third dorsal compartment** of the wrist [1]. - Its main function is to **extend the thumb's interphalangeal joint** and contributes to extension and adduction of the thumb. *Extensor pollicis brevis* - The **extensor pollicis brevis (EPB)** tendon is found in the **first dorsal compartment** of the wrist [1]. - It works with the abductor pollicis longus to form the **anatomical snuffbox** and primarily **extends the metacarpophalangeal joint** of the thumb [1]. *Abductor pollicis longus* - The **abductor pollicis longus (APL)** tendon is also located in the **first dorsal compartment** of the wrist [1]. - Its primary actions are to **abduct** (move away from the palm) and **extend the thumb** at the carpometacarpal joint [1].

Question 10: In pediatric assessment, a cephalic index of 75-80 is classified as:

A. Mesocephalic head shape (Correct Answer)
B. Dolichocephalic head shape
C. Brachycephalic head shape
D. Scaphocephalic head shape

Explanation: ***Mesocephalic head shape*** - A cephalic index between **75 and 80** indicates a **mesocephalic** head shape, which means the head has a medium or normal width-to-length ratio. - This is considered the **average** or typical head shape in most populations. *Dolichocephalic head shape* - A **dolichocephalic** head shape is characterized by a cephalic index typically **below 75**, meaning the head is relatively **long and narrow**. - This head shape is often seen in individuals with certain genetic backgrounds or conditions that affect skull development. *Brachycephalic head shape* - A **brachycephalic** head shape is characterized by a cephalic index typically **above 80**, meaning the head is relatively **short and wide**. - This can be naturally occurring or a result of conditions like **craniosynostosis** [1] or positional molding. *Scaphocephalic head shape* - **Scaphocephaly** is a specific type of **dolichocephaly** resulting from the premature fusion of the **sagittal suture** [1]. - This condition leads to a very long, narrow, and keeled head shape that would fall into the severe dolichocephalic range (cephalic index well below 75).