The upper part of the uncinate process commonly attaches to?
A patient presented to OPD with ophthalmoplegia and ptosis. Diagnosis of superior orbital fissure syndrome was confirmed after examination. Which nerves are compressed in this case ?
The artery that is palpated between the medial malleolus and the calcaneal tendon is?
FMGE 2025 - Anatomy FMGE Practice Questions and MCQs
Question 31: The upper part of the uncinate process commonly attaches to?
- A. Superior turbinate
- B. Middle turbinate (Correct Answer)
- C. Bulla ethmoidalis
- D. Inferior turbinate
Explanation: ***Middle turbinate***- The superior free end of the **uncinate process** most commonly attaches to the lateral surface of the body of the **middle turbinate** (occurring in approximately 60-70% of individuals).- This insertion variation is crucial as it determines the relationship between the **ethmoidal infundibulum** and the **frontal recess**.*Superior turbinate*- The **superior turbinate** is situated superiorly and posteriorly, often shielding the posterior ethmoid air cells.- The uncinate process is an anterior ethmoid structure and its attachments occur far inferior to the superior turbinate level.*Inferior turbinate*- The **inferior turbinate** is a separate, large bone that defines the **inferior meatus**, which contains the opening of the nasolacrimal duct.- The uncinate process lies superior to the inferior turbinate and is associated with the middle meatus.*Bulla ethmoidalis*- The **bulla ethmoidalis** is a large, fixed anterior ethmoid air cell located posterior to the **uncinate process**.- The space defined between the uncinate process anteriorly and the bulla ethmoidalis posteriorly is the **hiatus semilunaris**.
Question 32: A patient presented to OPD with ophthalmoplegia and ptosis. Diagnosis of superior orbital fissure syndrome was confirmed after examination. Which nerves are compressed in this case ?
- A. III, IV, V1, V2
- B. III, IV, V1, VI (Correct Answer)
- C. II, III, IV, V1
- D. II, III, IV, VI
Explanation: ***III, IV, V1, VI*** - The **superior orbital fissure** is a critical anatomical passage that transmits the **oculomotor nerve (III)**, **trochlear nerve (IV)**, the **ophthalmic division of the trigeminal nerve (V1)**, and the **abducens nerve (VI)**. - Compression of these nerves collectively results in **ophthalmoplegia** (paralysis of eye muscles due to III, IV, VI involvement [1]) and **ptois** (drooping of the upper eyelid due to III involvement), which are the classic signs of superior orbital fissure syndrome. *III, IV, V1, V2* - This option is incorrect because the **maxillary division of the trigeminal nerve (V2)** does not pass through the superior orbital fissure. - V2 exits the skull through the **foramen rotundum** to supply the maxillary region, and is therefore not affected in this syndrome. *II, III, IV, VI* - This option is incorrect because the **optic nerve (II)** is not involved in superior orbital fissure syndrome. - The optic nerve passes through the **optic canal**, a separate opening. Involvement of the optic nerve would cause vision loss and indicate a more extensive condition like **orbital apex syndrome**. *II, III, IV, V1* - This is incorrect as it includes the **optic nerve (II)**, which, as mentioned, travels through the optic canal, not the superior orbital fissure. - The absence of vision loss or an **afferent pupillary defect** helps differentiate superior orbital fissure syndrome from pathologies involving the optic nerve.
Question 33: The artery that is palpated between the medial malleolus and the calcaneal tendon is?
- A. Popliteal artery
- B. Anterior tibial artery
- C. Dorsalis pedis artery
- D. Posterior tibial artery (Correct Answer)
Explanation: ***Posterior tibial artery*** - This artery passes through the **tarsal tunnel**, located just posterior to the **medial malleolus** and anterior to the **calcaneal (Achilles) tendon**, making it the palpable artery at this specific site. - The **posterior tibial artery** pulse is a critical component of the lower limb vascular examination, essential for assessing blood supply to the foot, especially in cases of **peripheral arterial disease** [1]. *Anterior tibial artery* - This artery is located on the **anterior aspect** of the leg and ankle, running down the front of the leg between the tibia and fibula. - It becomes the **dorsalis pedis artery** as it crosses the ankle joint, so it is not found behind the medial malleolus. *Dorsalis pedis artery* - This artery is palpated on the **dorsum (top) of the foot**, typically lateral to the tendon of the extensor hallucis longus. - As a continuation of the **anterior tibial artery**, its pulse point is anatomically distinct from the area between the medial malleolus and the calcaneal tendon. *Popliteal artery* - The **popliteal artery** is found deep within the **popliteal fossa**, the space behind the knee joint. - It is a much more proximal vessel that bifurcates into the **anterior and posterior tibial arteries** well above the ankle.