FMGE 2019 — Anatomy
13 Previous Year Questions with Answers & Explanations
Most prominent and largest air cell of ethmoidal sinus?
Ventricles are lined by?
Highest point of iliac crest is seen at?
Celiac vessel is seen at which vertebral level?
Middle meningeal artery is a branch of which artery?
Which of the following is the safety muscle of tongue?
Protrusion of mandible is due to which of the following muscles?
Which structure doesn't pass through the parotid gland?
In which location is a transplanted kidney typically placed?
Testicular artery is a branch of -
FMGE 2019 - Anatomy FMGE Practice Questions and MCQs
Question 1: Most prominent and largest air cell of ethmoidal sinus?
- A. Onodi cell
- B. Bulla ethmoidalis (Correct Answer)
- C. Haller cell
- D. Agger nasi cell
Explanation: ***Bulla ethmoidalis*** - The **bulla ethmoidalis** is universally present and is consistently described as the **largest and most prominent** of the anterior ethmoid air cells. - It forms an anatomical landmark that is consistently superior and posterior to the **hiatus semilunaris**. *Onodi cell* - The **Onodi cell** is a posterior ethmoid air cell that pneumatizes laterally and superiorly into the sphenoid bone, in close proximity to the optic nerve. - While clinically significant due to its relationship with the optic nerve, it is not the largest or most prominent ethmoidal air cell. *Haller cell* - A **Haller cell** is an infraorbital ethmoid cell located along the floor of the orbit, extending into the maxillary sinus. - These cells can contribute to **ostial obstruction** of the maxillary sinus but are typically small compared to the bulla ethmoidalis. *Agger nasi cell* - The **agger nasi cell** is the most anterior ethmoid air cell, located in the lacrimal bone anterior to the frontal recess. - It is often one of the first ethmoid cells to pneumatize but is generally small and not considered the most prominent.
Question 2: Ventricles are lined by?
- A. Schwann cells
- B. Oligodendrocytes
- C. Ependymal cells (Correct Answer)
- D. Astrocytes
Explanation: Ependymal cells - Ependymal cells are a type of glial cell that form the epithelial lining of the ventricles of the brain and the central canal of the spinal cord [3]. - They possess cilia that help circulate the cerebrospinal fluid (CSF) and microvilli involved in CSF absorption. Schwann cells - Schwann cells are responsible for forming the myelin sheath around axons in the peripheral nervous system (PNS) [4]. - They do not line the ventricles, which are part of the central nervous system [2]. Oligodendrocytes - Oligodendrocytes are glial cells that form the myelin sheath around axons in the central nervous system (CNS) [1], [4]. - While they are CNS cells, their primary function is myelination, not lining the ventricular system [1]. Astrocytes - Astrocytes are the most abundant and diverse glial cells in the CNS, providing structural support, metabolic regulation, and forming the blood-brain barrier. - They are found throughout the brain parenchyma but do not directly line the ventricular cavities.
Question 3: Highest point of iliac crest is seen at?
- A. L3
- B. L4 (Correct Answer)
- C. S2
- D. S1
Explanation: ***L4*** - The **highest point of the iliac crest** typically corresponds to the level of the **L4 vertebral body**. - This anatomical landmark is crucial for procedures like **lumbar punctures** and determining the location for **epidural anesthesia**. *L3* - The L3 vertebral level is generally located slightly **above the highest point of the iliac crest**. - While close, it is not the most consistent anatomical correlation for the highest point. *S2* - The **S2 vertebral level** is significantly **below the iliac crests**, marking the approximate midpoint of the sacroiliac joint. - This level is used as a landmark for the **dermatome of the posterior thigh**. *S1* - The **S1 vertebral level** is also located **below the iliac crests**, forming the most superior segment of the sacrum. - It is used as a landmark for the **dermatome of the lateral foot and posterior leg**, and corresponds to the ankle jerk reflex.
Question 4: Celiac vessel is seen at which vertebral level?
- A. L2
- B. T9
- C. T12 (Correct Answer)
- D. T10
Explanation: T12 - The celiac trunk arises from the abdominal aorta at the level of the twelfth thoracic vertebra (T12), just below the aortic hiatus of the diaphragm. - This is typically at the level of the upper border of L1 or lower border of T12. - It is the first major unpaired visceral branch and supplies the foregut organs (stomach, proximal duodenum, liver, spleen, pancreas). L2 - The renal arteries, which supply the kidneys, typically originate from the aorta at the level of the L1-L2 vertebra. - The inferior mesenteric artery (IMA) arises at approximately L3 level. - This level is significantly lower than the origin of the celiac trunk. T9 - At the level of T9, no major visceral branches arise from the aorta. - This level is above the aortic hiatus (at T12), so the aorta is still in the thoracic cavity. - The celiac trunk has not yet branched at this higher level. T10 - At T10, the aorta is still in the thoracic cavity, passing through the posterior mediastinum. - The aortic hiatus of the diaphragm is at T12, not T10. - No major unpaired visceral branches originate at this level.
Question 5: Middle meningeal artery is a branch of which artery?
- A. Maxillary artery (Correct Answer)
- B. Superficial temporal artery
- C. Facial artery
- D. Ophthalmic artery
Explanation: ***Maxillary artery*** - The **middle meningeal artery** is a major branch of the **maxillary artery**, which itself is a terminal branch of the **external carotid artery**. - It supplies blood to the **dura mater** and cranial bones and is notably vulnerable to injury in temporal bone fractures. *Superficial temporal artery* - The **superficial temporal artery** is the other terminal branch of the **external carotid artery** (alongside the maxillary artery). - It supplies the scalp and superficial temporal region but does not give rise to the middle meningeal artery. *Facial artery* - The **facial artery** is a branch of the **external carotid artery** but primarily supplies structures of the face, such as muscles of facial expression and superficial facial tissues. - It does not give rise to the middle meningeal artery, which has an intracranial course. *Ophthalmic artery* - The **ophthalmic artery** is a branch of the **internal carotid artery** and supplies structures within the orbit, including the eye. - It does not contribute to the blood supply of the dura mater in the area supplied by the middle meningeal artery.
Question 6: Which of the following is the safety muscle of tongue?
- A. Genioglossus (Correct Answer)
- B. Hyoglossus
- C. Styloglossus
- D. Palatoglossus
Explanation: ***Genioglossus*** - The **genioglossus muscle** is considered the safety muscle of the tongue because its contraction pulls the tongue forward, preventing it from falling backward and **obstructing the airway**, especially during sleep or in an unconscious state. - Its forward action is crucial in maintaining a **patent airway** [1]. *Hyoglossus* - The **hyoglossus muscle** depresses and retracts the tongue. - Its primary action is not to prevent airway obstruction, but rather for **tongue movement** during speech and swallowing. *Styloglossus* - The **styloglossus muscle** retracts and elevates the tongue. - It helps in shaping the tongue for **swallowing and speech**, but does not have a primary role in airway patency. *Palatoglossus* - The **palatoglossus muscle** elevates the posterior part of the tongue and depresses the soft palate. - It is involved in initiating **swallowing** and separating the oral cavity from the pharynx, not in preventing airway collapse.
Question 7: Protrusion of mandible is due to which of the following muscles?
- A. Medial pterygoid
- B. Masseter
- C. Lateral pterygoid (Correct Answer)
- D. Temporalis
Explanation: ***Lateral pterygoid*** - The **lateral pterygoid muscle** is the primary muscle responsible for **protrusion of the mandible**. - Its bilateral contraction pulls the condyle of the mandible and the articular disc anteriorly, causing the lower jaw to move forward. *Medial pterygoid* - The **medial pterygoid muscle** primarily functions in **elevation** and **side-to-side movements** of the mandible. - While it assists in some mandibular movements, its main role is not protrusion. *Masseter* - The **masseter muscle** is a strong muscle involved in **elevating the mandible** and is crucial for **closing the jaw** (biting and chewing). - It does not contribute significantly to the forward movement or protrusion of the mandible. *Temporalis* - The **temporalis muscle** is a major muscle of mastication, responsible for **elevating the mandible** and **retracting** it. - Its fibers, particularly the posterior ones, pull the mandible backward, directly opposing protrusion.
Question 8: Which structure doesn't pass through the parotid gland?
- A. Retromandibular vein
- B. Facial nerve
- C. External Carotid Artery and its branches
- D. Internal Carotid Artery (Correct Answer)
Explanation: ***Internal Carotid Artery*** - The **internal carotid artery** does not pass through the parotid gland; it is located medial to the gland. - It ascends in the neck to supply the brain and does not traverse the glandular parenchyma. *Retromandibular vein* - The retromandibular vein is formed within the parotid gland by the union of the **superficial temporal vein** and the **maxillary vein**. - It then exits the gland and divides into anterior and posterior divisions. *Facial nerve* - The **facial nerve (cranial nerve VII)** enters the posterior aspect of the parotid gland and divides into its five terminal branches within the gland. - It supplies motor innervation to the **muscles of facial expression**. *External Carotid Artery and its branches* - The **external carotid artery** passes through the parotid gland, where it gives off several important branches. - The main branches within the gland are the **maxillary artery** and the **superficial temporal artery**.
Question 9: In which location is a transplanted kidney typically placed?
- A. Retroperitoneal space
- B. Hypogastric region
- C. Iliac fossa (Correct Answer)
- D. Kidney fossa
Explanation: ***Iliac fossa*** - The **iliac fossa** is the standard site for kidney transplantation due to its accessibility and the proximity of suitable blood vessels (iliac artery and vein) for anastomosis. [1] - Placing the kidney here allows for easier access for potential biopsies and monitoring. *Retroperitoneal space* - The patient's native kidneys are located in the **retroperitoneal space**, but a transplanted kidney is typically placed in a more accessible anterior location. - Transplanting a kidney into the retroperitoneal space would be a more complex and invasive procedure due to the depth and surrounding structures. *Hypogastric region* - While the iliac fossa is part of the broader hypogastric region, the term **hypogastric region** is less specific for the precise anatomical location of kidney transplantation. - The iliac fossa specifically refers to the concave surface of the ilium, which provides a suitable bed for the donated kidney. *Kidney fossa* - **Kidney fossa** is not a formally recognized anatomical term for a specific site of kidney transplantation. - The term "fossa" describes a depression or hollow, but in the context of transplantation, the iliac fossa is the correct anatomical landmark used.
Question 10: Testicular artery is a branch of -
- A. Common iliac artery
- B. External iliac artery
- C. Internal iliac artery
- D. Abdominal aorta (Correct Answer)
Explanation: ***Abdominal aorta*** - The **testicular arteries**, also known as **gonadal arteries**, originate directly from the anterior aspect of the **abdominal aorta**. - They typically arise just inferior to the **renal arteries** at the level of the second lumbar vertebra (L2) and descend to supply the testes. *Common iliac artery* - The common iliac artery is a terminal branch of the **abdominal aorta**, but it gives rise to the internal and external iliac arteries, not directly the testicular artery. [2] - It bifurcates at the level of the sacroiliac joint. [3] *External iliac artery* - The external iliac artery primarily supplies the **lower limb** and gives off the inferior epigastric and deep circumflex iliac arteries. [1] - It does not directly provide branches to the testes. *Internal iliac artery* - The internal iliac artery primarily supplies the **pelvic organs**, gluteal region, and perineum. - While it has numerous branches, none of them are the main gonadal arteries; it contributes to the blood supply of the reproductive organs through other smaller branches. [3]