Which of the following muscles is not in the pectoral region?
Which of the following structures is not found in the midpalmar space?
Which is the primary muscle causing supination of the forearm?
All are infraclavicular branches of brachial plexus except ?
How many ossification centers develop at the distal end of the humerus?
What is the largest branch of the brachial plexus?
Which part of the heart is located in the anterosuperior sternal region?
Which muscle will be paralyzed when the radial nerve is injured just below the spiral groove?
Which muscle receives a muscular branch from the ulnar nerve?
What is the approximate ratio of connective tissue to smooth muscle in the cervix?
NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs
Question 41: Which of the following muscles is not in the pectoral region?
- A. Pectoralis major
- B. Infraspinatus (Correct Answer)
- C. Pectoralis minor
- D. Subclavius
Explanation: ***Infraspinatus*** - The **infraspinatus** muscle is located in the **posterior scapular region**, specifically on the posterior aspect of the scapula, filling the infraspinous fossa. - Its primary function is **external rotation** of the humerus, and it is a key component of the **rotator cuff**. *Pectoralis major* - The **pectoralis major** is a large, superficial muscle located in the **anterior chest wall**, forming the bulk of the chest. [1] - It plays a significant role in **adduction**, **flexion**, and **medial rotation** of the humerus. *Pectoralis minor* - The **pectoralis minor** is a smaller, triangular muscle situated beneath the pectoralis major in the **anterior thoracic wall**. [1] - Its functions include **stabilizing the scapula** by pulling it inferiorly and anteriorly, and assisting in forced inspiration. [1] *Subclavius* - The **subclavius** is a small, triangular muscle located inferior to the clavicle in the **pectoral region**. - Its primary role is to **depress and stabilize the clavicle**, protecting the underlying neurovascular structures.
Question 42: Which of the following structures is not found in the midpalmar space?
- A. 2nd lumbrical
- B. 1st lumbrical (Correct Answer)
- C. FDP of 4th finger
- D. FDP of 3rd finger
Explanation: ***1st lumbrical*** - The **1st lumbrical** is typically found within the **thenar space** or the **central compartment of the palm**, not the midpalmar space [1]. - Its position is associated with the **index finger's flexor tendons**, which do not traverse the midpalmar space. *2nd lumbrical* - The **2nd lumbrical** is located in the **midpalmar space**, situated on the radial side of the **flexor digitorum profundus (FDP) tendon** to the third digit [1]. - It arises from the radial side of the **FDP tendon** of the **middle finger** [1]. *FDP of 3rd finger* - The **flexor digitorum profundus (FDP) tendon** to the **third finger** (middle finger) passes through the **midpalmar space** [1]. - These tendons, along with their associated lumbricals, are key components of the **midpalmar space**. *FDP of 4th finger* - The **flexor digitorum profundus (FDP) tendon** to the **fourth finger** (ring finger) also travels through the **midpalmar space** [1]. - The midpalmar space contains the **FDP tendons** for the middle, ring, and little fingers, as well as their corresponding lumbricals (2nd, 3rd, and 4th).
Question 43: Which is the primary muscle causing supination of the forearm?
- A. Brachioradialis
- B. Anconeus
- C. Biceps brachii
- D. Supinator (Correct Answer)
Explanation: ***Supinator*** - The **supinator muscle** is the **primary muscle** responsible for **supination** of the forearm, rotating the palm anteriorly or superiorly. - It is a deep muscle of the **posterior compartment** of the forearm. - Its action is especially prominent when **supinating against resistance** or in very slow movements, as it works synergistically with the biceps brachii. *Biceps brachii* - While the **biceps brachii** is also a powerful **supinator** of the forearm, especially when the elbow is flexed, it is a **secondary supinator**. - It is primarily a major **flexor** of the elbow, whereas the supinator is dedicated specifically to supination. *Brachioradialis* - The **brachioradialis** is primarily a **flexor** of the forearm at the elbow joint. - It helps to bring the forearm into a **mid-prone or mid-supine position** from either full pronation or full supination, but does not actively supinate. *Anconeus* - The **anconeus** is a small muscle that assists the **triceps brachii** in **extension of the forearm** at the elbow. - It helps to **stabilize the elbow joint** and slightly abducts the ulna during pronation, but has no role in supination.
Question 44: 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 45: 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 46: 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 47: Which part of the heart is located in the anterosuperior sternal region?
- A. Right atrium and auricle.
- B. Left atrium.
- C. Left ventricle.
- D. Right ventricle. (Correct Answer)
Explanation: ***Right ventricle*** - The **right ventricle** forms the **most anterior part of the heart**, located directly behind the sternum and costal cartilages [1]. - Its position explains why **sternal precordial leads** (e.g., V1, V2) on an ECG primarily reflect right ventricular activity [1]. *Right atrium and auricle* - While part of the right atrium is anterior, the **right ventricle is significantly more anterior** and occupies the majority of the anterosuperior sternal region [1]. - The **right auricle** is a small, anterior appendage, but the broader chamber occupying this region is the ventricle [1]. *Left atrium* - The **left atrium** is the **most posterior chamber of the heart**, forming the base [1]. - It lies near the esophagus, making it susceptible to compression by an enlarged left atrium. *Left ventricle* - The **left ventricle** forms the **apex of the heart** and is located primarily on the **left and inferior** aspects. - It is not the most anterior structure; the right ventricle is positioned anteriorly to it [1].
Question 48: 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].
Question 49: 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 50: What is the approximate ratio of connective tissue to smooth muscle in the cervix?
- A. 2:1
- B. 5:1
- C. 15:1
- D. Approximately 8:1 (Correct Answer)
Explanation: ***Approximately 8:1*** - The **cervix** is predominantly composed of **fibrous connective tissue**, which provides its structural integrity and rigidity [1]. - This high ratio of **collagenous connective tissue** to smooth muscle is crucial for maintaining pregnancy and undergoing significant remodeling during parturition [1]. - The approximate ratio is **8:1 to 10:1**, with connective tissue forming about 85-90% of cervical tissue [1]. *2:1* - This ratio would imply a significantly higher proportion of **smooth muscle** (33%), making the cervix much more muscular and less fibrous than it actually is. - Such a composition would compromise the cervical function of maintaining a **closed uterine orifice** during pregnancy. *5:1* - While higher than 2:1, this ratio still underestimates the true dominance of **connective tissue** in the cervical structure. - The **cervix's mechanical properties**, including its ability to resist stretching, are primarily due to its abundant collagen content. *15:1* - This ratio overestimates the proportion of connective tissue, suggesting less than 7% smooth muscle. - While the cervix is indeed fibrous, it does contain a modest amount of **smooth muscle** (10-15%) particularly in the internal os region, making this ratio too extreme [1].