The cardiac jelly formed around the heart tube during early development contributes to the formation of:
Collecting part of kidney develops from ?
Which muscle is derived from the third pharyngeal arch?
Which muscle receives a muscular branch from the ulnar nerve?
How many ossification centers develop at the distal end of the humerus?
What is the largest branch of the brachial plexus?
Which of the following statements regarding axillary lymph nodes is incorrect?
All are infraclavicular branches of brachial plexus except ?
A person had injury to right upper limb, he is not able to extend fingers but able to extend wrist and elbow. Nerve injured is ?
Which muscle will be paralyzed when the radial nerve is injured just below the spiral groove?
NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs
Question 11: The cardiac jelly formed around the heart tube during early development contributes to the formation of:
- A. Pericardium
- B. Mesocardium
- C. Myocardium
- D. Endocardium (Correct Answer)
Explanation: Endocardium (Endocardial Cushions/Valves/Septa) - The **cardiac jelly** is an acellular, gelatinous matrix rich in **hyaluronic acid** that lies between the endocardium and the primordial myocardium during early heart development. - It undergoes **endothelial-to-mesenchymal transformation (EMT)** to form the **endocardial cushions** [1]. - These cushions are critical for forming: - **Atrioventricular (AV) valves** (mitral and tricuspid) [1] - **Semilunar valves** (aortic and pulmonary) [1] - **Cardiac septa** (portions of atrial, ventricular, and AV septa) [1] - While cardiac jelly doesn't form the endocardial lining itself (which is already present as endothelium), it forms the endocardial cushions that are essential endocardial derivatives. *Pericardium* - The **pericardium** develops from the **pleuropericardial folds** and **somatic and splanchnic mesoderm**, forming the fibrous and serous outer coverings of the heart. - It is completely distinct from cardiac jelly, which is an intra-cardiac structure. *Mesocardium* - The **dorsal mesocardium** is a transient mesentery that temporarily connects the developing heart tube to the dorsal wall of the pericardial cavity. - It rapidly degenerates by **day 22-23** to form the **transverse pericardial sinus**. - It does not contribute to cardiac jelly or any heart wall structures. *Myocardium* - The **myocardium** differentiates directly from the **splanchnic mesoderm** surrounding the endocardial tube. - It forms the muscular contractile layer of the heart wall. - Cardiac jelly lies between the endocardium and myocardium but does not form myocardial tissue.
Question 12: Collecting part of kidney develops from ?
- A. Mesonephros
- B. Metanephros
- C. Ureteric bud (Correct Answer)
- D. Pronephros
Explanation: ***Ureteric bud*** - The **ureteric bud** (also known as the metanephric diverticulum) is an outgrowth of the **mesonephric duct** that develops into the collecting system of the kidney. - It gives rise to the **ureter**, **renal pelvis**, major and minor calyces, and all collecting ducts. *Pronephros* - **Pronephros** is the earliest, most rudimentary, and transient excretory structure that appears in human embryos. - It is non-functional in humans and **degenerates completely** by the fourth week of gestation. *Mesonephros* - The **mesonephros** develops after the pronephros and functions as a temporary kidney during the early fetal period (weeks 4-8). - Its tubules primarily contribute to the **male reproductive system** (e.g., epididymis, ductus deferens) and **degenerate** in females. *Metanephros* - The **metanephros** is the definitive kidney in mammals and gives rise to the **nephrons** (glomeruli, Bowman's capsule, proximal and distal convoluted tubules, loop of Henle). - While it's crucial for kidney development, the **collecting part** specifically originates from the ureteric bud, which interacts with the metanephric mesenchyme.
Question 13: Which muscle is derived from the third pharyngeal arch?
- A. Tensor tympani
- B. Stylopharyngeus (Correct Answer)
- C. Cricothyroid
- D. Stapedius
Explanation: ***Stylopharyngeus*** - The **stylopharyngeus muscle** is uniquely derived from the **third pharyngeal arch**. - It is innervated by the **glossopharyngeal nerve (CN IX)** and plays a role in elevating the pharynx and larynx during swallowing. - This is the **only muscle** derived from the third pharyngeal arch, making it a key anatomical landmark. *Tensor tympani* - The **tensor tympani muscle** is derived from the **first pharyngeal arch**. - It is innervated by the **mandibular nerve (V3)** and dampens sound by tensing the tympanic membrane. *Cricothyroid* - The **cricothyroid muscle** is derived from the **fourth and sixth pharyngeal arches**. - It is innervated by the **external branch of the superior laryngeal nerve (CN X)** and tenses the vocal cords. *Stapedius* - The **stapedius muscle** is derived from the **second pharyngeal arch**. - It is innervated by the **facial nerve (CN VII)** and dampens sound by stabilizing the stapes bone.
Question 14: Which muscle receives a muscular branch from the ulnar nerve?
- A. Both FCU and FDP (Correct Answer)
- B. FCU
- C. None of the options
- D. FDP
Explanation: ***Both FCU and FDP*** - The **flexor carpi ulnaris (FCU)** is solely innervated by the **ulnar nerve** in the forearm. - The **flexor digitorum profundus (FDP)** has dual innervation: the **ulnar nerve** supplies the medial half (tendons to ring and little fingers), while the anterior interosseous nerve (branch of median nerve) supplies the lateral half (tendons to index and middle fingers). - Both muscles receive muscular branches from the ulnar nerve, making this the most complete and accurate answer. *FCU* - While the FCU does receive innervation from the ulnar nerve (and only the ulnar nerve), this option is incorrect because the FDP also receives branches from the ulnar nerve. - Selecting only FCU ignores the dual innervation of FDP and is therefore an incomplete answer when "Both FCU and FDP" is available. *FDP* - While the medial half of FDP does receive innervation from the ulnar nerve, this option is incorrect because FCU also receives innervation from the ulnar nerve. - Selecting only FDP ignores the complete innervation of FCU and is therefore an incomplete answer when "Both FCU and FDP" is available. *None of the options* - This option is incorrect because both the **flexor carpi ulnaris** and the medial portion of the **flexor digitorum profundus** definitively receive muscular branches from the ulnar nerve. - The ulnar nerve provides motor innervation to these specific forearm muscles before continuing into the hand.
Question 15: How many ossification centers develop at the distal end of the humerus?
- A. 2
- B. 3 (Correct Answer)
- C. 5
- D. 4
Explanation: ***3*** - The distal end of the humerus develops **three primary ossification centers**: the capitellum, trochlea, and medial epicondyle [1]. - These centers appear sequentially and their ossification pattern is important for assessing **skeletal maturity** in children using the CRITOE mnemonic [1]. - The capitellum appears at 1 year, medial epicondyle at 5 years, and trochlea at 9 years. *2* - This number is too low and only accounts for the **capitellum and medial epicondyle**, missing the trochlea. - While these are the first two to appear, there is an additional primary ossification center (trochlea) that develops later. *5* - This number is incorrect; there are only **three primary ossification centers** at the distal humerus, not five. - This may cause confusion with other joints or by counting secondary ossification centers. *4* - This number is incorrect; while the lateral epicondyle does ossify, it is not consistently counted as a **primary ossification center**. - The standard anatomical teaching recognizes **three primary centers**: capitellum, trochlea, and medial epicondyle.
Question 16: What is the largest branch of the brachial plexus?
- A. Ulnar nerve
- B. Radial nerve (Correct Answer)
- C. Axillary nerve
- D. Median nerve
Explanation: ***Radial nerve*** - The **radial nerve** is considered the largest branch of the brachial plexus due to its extensive innervation of numerous muscles in the posterior compartment of the arm and forearm. - It arises from the **posterior cord** of the brachial plexus and innervates all the extensors of the arm and forearm, including the triceps brachii and supinator. *Ulnar nerve* - The ulnar nerve is a significant branch, but it is **smaller** in cross-sectional area and muscular distribution compared to the radial nerve. - It mainly innervates muscles of the **hand** and some forearm flexors. *Median nerve* - The median nerve is a large and clinically important nerve, formed by contributions from both the **lateral and medial cords**, but it is generally *not* considered the largest in terms of overall bulk or number of muscular branches. - It primarily innervates the **flexor muscles of the forearm** and some muscles of the hand (thenar eminence). *Axillary nerve* - The axillary nerve is one of the **smaller** terminal branches of the brachial plexus. - It primarily innervates the **deltoid** and **teres minor muscles**, and a small area of skin over the shoulder.
Question 17: Which of the following statements regarding axillary lymph nodes is incorrect?
- A. Posterior group lies along subscapular vessels
- B. Lateral group lies along lateral thoracic vessels (Correct Answer)
- C. Apical group is terminal lymph nodes
- D. Apical group lies along axillary vessels
Explanation: ***Lateral group lies along lateral thoracic vessels*** - The **lateral group** of axillary lymph nodes is located along the **axillary vein**, receiving lymph primarily from the upper limb [1]. - The **lateral thoracic vessels** are associated with the central and posterior groups of axillary lymph nodes, not the lateral group. *Posterior group lies along subscapular vessels* - The **posterior (subscapular) group** of axillary lymph nodes is indeed located along the **subscapular vessels**. - This group receives lymph from the posterior wall of the trunk and the posterior shoulder region. *Apical group is terminal lymph nodes* - The **apical group** (also known as the subclavian group) is considered the **terminal lymph nodes** of the axilla. - Lymph from all other axillary nodes eventually drains into the apical group before continuing to the supraclavicular nodes and then into the subclavian lymphatic trunk [2]. *Apical group lies along axillary vessels* - The **apical group** of axillary lymph nodes is situated in the apex of the axilla, superior to the pectoralis minor muscle, and lies in close proximity to the **axillary vessels** [1]. - This location allows it to receive lymph from other axillary groups and drain into the supraclavicular lymph nodes.
Question 18: All are infraclavicular branches of brachial plexus except ?
- A. Axillary nerve
- B. Thoracodorsal nerve
- C. Long thoracic nerve (Correct Answer)
- D. Ulnar nerve
Explanation: Long thoracic nerve - The long thoracic nerve originates directly from the roots (C5, C6, C7) of the brachial plexus, making it a supraclavicular branch. - It does not arise from the cords of the brachial plexus, which are located infraclavicularly. Ulnar nerve - The ulnar nerve arises from the medial cord of the brachial plexus, which is an infraclavicular structure. - It supplies many intrinsic hand muscles and the ulnar half of the flexor digitorum profundus. Axillary nerve - The axillary nerve is a branch of the posterior cord of the brachial plexus, classifying it as an infraclavicular branch. - It innervates the deltoid and teres minor muscles. Thoracodorsal nerve - The thoracodorsal nerve also originates from the posterior cord of the brachial plexus, making it an infraclavicular branch [1]. - It provides motor innervation to the latissimus dorsi muscle [1].
Question 19: A person had injury to right upper limb, he is not able to extend fingers but able to extend wrist and elbow. Nerve injured is ?
- A. Median
- B. Ulnar
- C. Radial
- D. Posterior interosseous (Correct Answer)
Explanation: ***Posterior interosseous*** - This nerve supplies the muscles responsible for **finger extension**, such as the **extensor digitorum**, **extensor indicis**, and **extensor digiti minimi**. - A lesion here would spare wrist and elbow extension because the nerves to the **extensor carpi radialis longus/brevis** and **triceps brachii** branch off the radial nerve proximal to the origin of the posterior interosseous nerve. *Radial* - A more proximal **radial nerve injury** would result in the inability to extend the wrist (leading to **wrist drop**), fingers, and thumb, which is not seen here as wrist extension is preserved. - It also innervates the **triceps brachii**, and a high radial nerve injury would affect elbow extension; this patient can extend their elbow. *Median* - The **median nerve** primarily innervates muscles responsible for **flexion** of the wrist and fingers, as well as **thumb opposition** and **pronation**. - Its injury would not directly lead to an inability to extend the fingers, but rather weakness in flexion and specific thumb movements. *Ulnar* - The **ulnar nerve** innervates most of the **intrinsic hand muscles** and the **flexor carpi ulnaris**, leading to weakness in finger abduction/adduction and flexion of the 4th and 5th digits. - It does not control finger extension, so an injury would not cause this specific deficit.
Question 20: Which muscle will be paralyzed when the radial nerve is injured just below the spiral groove?
- A. Extensor Digitorum
- B. Extensor Carpi Radialis Brevis (Correct Answer)
- C. Supinator
- D. Abductor Pollicis Longus
Explanation: Extensor Carpi Radialis Brevis - The radial nerve travels in the spiral groove of the humerus and gives off branches in a specific sequence. - Proximal to the spiral groove: Branches to triceps and anconeus - Within/at the spiral groove: Branches to brachioradialis and extensor carpi radialis longus (ECRL) - Just distal to the spiral groove: Branch to extensor carpi radialis brevis (ECRB) [1] - this is the first branch after exiting the spiral groove - More distally: The nerve divides into superficial and deep branches (posterior interosseous nerve) [1] - An injury just below the spiral groove would paralyze ECRB while sparing muscles innervated proximal to or within the groove (triceps, anconeus, brachioradialis, ECRL). Supinator - The supinator is innervated by the deep branch of the radial nerve (posterior interosseous nerve), which branches off more distally in the proximal forearm. - This muscle would only be affected by injuries distal to the bifurcation of the radial nerve into superficial and deep branches, not by an injury just below the spiral groove. Extensor Digitorum - The extensor digitorum is supplied by the posterior interosseous nerve, which is a continuation of the deep branch [1]. - This innervation occurs significantly distal to the spiral groove in the posterior forearm compartment. - It would be affected by posterior interosseous nerve injuries, not by lesions just below the spiral groove. Abductor Pollicis Longus - The abductor pollicis longus is innervated by the posterior interosseous nerve in the distal forearm [1]. - This is the most distal of all the options and would only be affected by posterior interosseous nerve palsy, not by radial nerve injury at the spiral groove level [1].