Anatomy
3 questionsAt which level do the somites initially form?
The cardiac jelly formed around the heart tube during early development contributes to the formation of:
Mastoid process is which type of epiphysis?
NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs
Question 71: At which level do the somites initially form?
- A. Lumbar level
- B. Sacral level
- C. Cervical level (Correct Answer)
- D. Thoracic level
Explanation: Cervical level - Somites, which are segmented blocks of paraxial mesoderm, initially appear in the **occipital/cranial cervical region** of the developing embryo around day 20 of development. - The first somite pair forms at the **occipital level**, and subsequent somites develop in a **cranio-caudal sequence**. - Development proceeds both cranially (forming occipital somites) and caudally (forming cervical, thoracic, lumbar, and sacral somites) from this initial formation. - By the end of the 5th week, approximately **42-44 somite pairs** are present. *Thoracic level* - Thoracic somites form subsequent to the initial occipital/cervical somites, as the segmentation process extends caudally. - The formation of somites is a sequential process along the **cranio-caudal axis**. *Lumbar level* - Lumbar somites develop later in the embryological timeline, after the cervical and thoracic regions have undergone somite formation. - The **caudal regions** receive somites progressively as development continues. *Sacral level* - Sacral somites are among the last to form, representing the caudal extent of somite development. - Their formation follows the cranio-caudal progression of somite appearance.
Question 72: 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 73: Mastoid process is which type of epiphysis?
- A. Pressure epiphysis
- B. Traction epiphysis (Correct Answer)
- C. Atavistic epiphysis
- D. Aberrant epiphysis
Explanation: Traction epiphysis - A traction epiphysis is an apophysis that does not contribute to the longitudinal growth of the bone but is located at the site of muscle attachment, serving to provide leverage for the muscle. - The mastoid process serves as an attachment point for various muscles, including the sternocleidomastoid, splenius capitis, and longissimus capitis, making it a classic example of a traction epiphysis. Pressure epiphysis - A pressure epiphysis is primarily responsible for the longitudinal growth of bone and is found at the ends of long bones, such as the femoral head or humeral head [1]. - The mastoid process does not contribute to longitudinal bone growth. Atavistic epiphysis - Atavistic epiphyses are those that are phylogenetically separate bones but become fused with the main bone during development, like the coracoid process of the scapula. - The mastoid process is an integral part of the temporal bone and is not considered a separate, phylogenetically distinct bone. Aberrant epiphysis - Aberrant epiphyses are variations that appear irregularly, are not always present, and do not have a consistent physiological role. - The mastoid process is a constant anatomical feature of the temporal bone in humans.
Internal Medicine
1 questionsMigraine is due to
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 71: Migraine is due to
- A. Cortical spreading depression (Correct Answer)
- B. Dilatation of cranial blood vessels
- C. Constriction of cranial blood vessels
- D. Inflammation of the meninges
Explanation: ***Cortical spreading depression*** - The current understanding is that **cortical spreading depression (CSD)** is the initiating event in migraine with aura, characterized by a wave of neuronal and glial depolarization that spreads across the cerebral cortex, leading to a temporary shutdown of neuronal activity [1]. - CSD is thought to activate the **trigeminal nerve**, subsequently causing the release of inflammatory neuropeptides and contributing to the pain phase [1]. *Dilatation of cranial blood vessels* - While **vasodilation of intracranial and extracranial blood vessels** does occur during the headache phase of migraine, it is now considered a *consequence* of the initial neurological events rather than the primary cause [1]. - This vasodilation contributes to the throbbing sensation of migraine pain but does not explain the aura or the initiation of the attack. *Constriction of cranial blood vessels* - **Vasoconstriction** was previously thought to be the cause of the migraine aura, but this theory has largely been disproven. - While some temporary constriction may precede CSD, it is not the primary mechanism behind the migraine attack. *Inflammation of the meninges* - While **neurogenic inflammation** of the meninges, involving the release of inflammatory mediators like **calcitonin gene-related peptide (CGRP)**, does play a role in sensitizing the trigeminal system and contributing to migraine pain, it is a downstream effect. - It is not the initial trigger for a migraine attack but rather part of the pain pathway activated by events like CSD.
Pediatrics
1 questionsWhat is the significance of the persistence of the asymmetric tonic neck reflex in a 9-month-old infant?
NEET-PG 2013 - Pediatrics NEET-PG Practice Questions and MCQs
Question 71: What is the significance of the persistence of the asymmetric tonic neck reflex in a 9-month-old infant?
- A. Decreased muscle tone
- B. Increased muscle tone (Correct Answer)
- C. Normal phenomenon
- D. None of the options
Explanation: ***Increased muscle tone*** - The **asymmetric tonic neck reflex (ATNR)** should integrate by **6 months of age**, and its persistence beyond this period is a sign of **neurological dysfunction**. - Persistent primitive reflexes, including ATNR, are often associated with **upper motor neuron lesions** and can manifest as increased muscle tone or **spasticity**. *Decreased muscle tone* - **Decreased muscle tone**, or **hypotonia**, is typically associated with **lower motor neuron lesions** or certain genetic conditions, not the persistence of primitive reflexes. - While some neurological conditions can cause hypotonia, persistent ATNR is a hallmark of problems leading to **hypertonia**. *Normal phenomenon* - The persistence of the ATNR beyond **6 months of age** is considered abnormal and indicates a potential developmental delay or neurological issue. - In a **9-month-old**, the reflex should have fully integrated, and its presence warrants further investigation. *None of the options* - As the persistence of the ATNR is indeed a significant finding, associated with increased muscle tone, this option is incorrect.
Physiology
5 questionsNormal renal threshold for glucose is at plasma glucose level ?
Cell bodies of orexigenic neurons are present in?
What is the primary solute responsible for the hyperosmolarity of the renal medulla?
Spinal pathway mainly regulating fine motor activity?
What is the normal cerebral blood flow in milliliters per minute for a healthy adult?
NEET-PG 2013 - Physiology NEET-PG Practice Questions and MCQs
Question 71: Normal renal threshold for glucose is at plasma glucose level ?
- A. 100 mg/dl
- B. 200 mg/dl (Correct Answer)
- C. 300 mg/dl
- D. 400 mg/dl
Explanation: ** _200 mg/dl_ ** - The **renal threshold for glucose** represents the plasma glucose concentration at which the kidneys begin to excrete glucose into the urine. - This typically occurs when the glucose level exceeds the reabsorptive capacity of the renal tubules, usually around **180-200 mg/dL**. * _100 mg/dl_ * - A plasma glucose level of **100 mg/dL** is within the normal fasting range and well below the renal threshold. - At this level, virtually all filtered glucose is reabsorbed by the renal tubules, and no glucose appears in the urine. * _300 mg/dl_ * - A plasma glucose level of **300 mg/dL** is significantly above the renal threshold for glucose. - At this concentration, the kidney's reabsorptive capacity is overwhelmed, leading to substantial **glucosuria** (glucose in the urine). * _400 mg/dl_ * - A plasma glucose level of **400 mg/dL** is severely elevated and far exceeds the renal threshold. - This level would result in significant glucose excretion in the urine and is indicative of uncontrolled hyperglycemia, as seen in **diabetes mellitus**.
Question 72: Cell bodies of orexigenic neurons are present in?
- A. Dorsal raphe
- B. Locus coeruleus
- C. Lateral hypothalamic area (Correct Answer)
- D. Hippocampus
Explanation: ***Lateral hypothalamic area*** - The **lateral hypothalamic area** (LHA) contains neurons that produce **orexin (hypocretin)**, a neuropeptide critical for promoting appetite and wakefulness. - Stimulation of the LHA leads to increased food seeking and consumption, earning it the moniker "**feeding center**." *Dorsal raphe* - The **dorsal raphe nucleus** is a key source of **serotonin** in the brain, involved in mood, sleep-wake cycles, and appetite regulation (often promoting satiety). - It does not primarily house orexigenic neurons that directly stimulate appetite. *Locus coerulus* - The **locus coeruleus** is the primary source of **norepinephrine** in the brain, playing a significant role in arousal, attention, and stress response. - While it modulates appetitive behaviors indirectly, its neurons are not the primary orexigenic cell bodies. *Hippocampus* - The **hippocampus** is crucial for **learning, memory formation**, and spatial navigation. - It is not directly involved in the primary neural circuits that control hunger and satiety through orexigenic neuropeptides.
Question 73: What is the primary solute responsible for the hyperosmolarity of the renal medulla?
- A. urea
- B. K
- C. Na (Correct Answer)
- D. Cl
Explanation: ***Na*** - **Sodium (Na+), along with chloride**, is the primary solute responsible for establishing the **corticomedullary osmotic gradient** in the renal medulla. - Actively reabsorbed in the **thick ascending limb of the loop of Henle** via the Na-K-2Cl cotransporter, creating hyperosmolarity in the outer medulla. - NaCl accounts for the majority of osmolality in the **outer medulla** and provides the foundation for the countercurrent multiplication system. - While **urea contributes significantly to inner medullary hyperosmolarity** (especially during antidiuresis), **sodium chloride** is considered the **primary driving force** for the overall medullary concentration gradient. *K* - **Potassium (K+)** is primarily involved in maintaining intracellular fluid balance and cellular membrane potentials. - While K+ is reabsorbed in the loop of Henle (via Na-K-2Cl cotransporter), it does not accumulate in the medullary interstitium to contribute significantly to hyperosmolarity. *urea* - **Urea** contributes substantially to hyperosmolarity, particularly in the **inner medulla** (accounting for ~40-50% of inner medullary osmolality). - Through **urea recycling** (collecting duct → medullary interstitium → thin limbs), it enhances urinary concentration, especially during water deprivation. - However, the **initial establishment** of the osmotic gradient depends on **NaCl reabsorption** in the ascending limb, making sodium the primary solute. *Cl* - **Chloride (Cl-)** is reabsorbed together with sodium via the Na-K-2Cl cotransporter in the thick ascending limb. - Functionally, **NaCl works as a unit** to create medullary hyperosmolarity, so chloride and sodium are inseparable in this process. - Among the listed options, **sodium** represents this NaCl contribution as the cation driving active transport.
Question 74: Spinal pathway mainly regulating fine motor activity?
- A. Lateral corticospinal tract (Correct Answer)
- B. Vestibulospinal tract
- C. Anterior corticospinal tract
- D. Reticulospinal tract
Explanation: ***Lateral corticospinal tract*** - This pathway contains **85-90% of corticospinal fibers** that cross at the medullary pyramids and descend in the **lateral funiculus** of the spinal cord - It is the **primary pathway for fine, precise, voluntary movements** of **distal extremities**, particularly the hands, fingers, feet, and toes - Enables intricate skilled movements like writing, buttoning, and fine manipulation due to direct monosynaptic connections to motor neurons - Damage results in loss of fine motor control and skilled movements *Anterior corticospinal tract* - Contains only **10-15% of corticospinal fibers** that descend uncrossed in the anterior spinal cord - Controls **bilateral movements of axial and proximal muscles** (neck, trunk, shoulders) - Not specialized for fine motor control of distal limbs *Vestibulospinal tract* - Regulates **posture and balance** by modulating extensor muscle tone - Coordinates head position and maintains upright posture - Does not control fine voluntary movements *Reticulospinal tract* - Modulates **muscle tone, posture, and locomotion** - Provides general motor control and autonomic regulation - Not specialized for precise, intricate fine motor movements
Question 75: What is the normal cerebral blood flow in milliliters per minute for a healthy adult?
- A. 55 ml/min
- B. 150 ml/min
- C. 750 ml/min (Correct Answer)
- D. 1000 ml/min
Explanation: ***750 ml/min*** - The brain receives approximately **15% of the cardiac output**, which for an average adult with a cardiac output of 5 L/min (5000 ml/min) translates to about **750 ml/min**. - This flow rate is essential to meet the high metabolic demands of the brain, which consumes about **20% of the body's total oxygen**. - For reference, this corresponds to approximately **50-55 ml/100g/min** when normalized to brain tissue weight. *55 ml/min* - This value represents the **cerebral blood flow per 100 grams of brain tissue** (50-55 ml/100g/min), not the **total cerebral blood flow**. - As a total flow value, 55 ml/min would be severely **inadequate** for the entire brain (~1400g) and would lead to immediate **ischemia** and neurological dysfunction. *150 ml/min* - While higher than 55 ml/min, this rate is still **grossly insufficient** to maintain the metabolic needs of the entire adult brain. - Such a low total flow would result in widespread **cerebral hypoperfusion** and severe neurological deficits. *1000 ml/min* - Although the brain has significant blood flow, 1000 ml/min is generally **higher than the normal average** for a healthy adult at rest. - The normal range is typically **750-800 ml/min**; sustained flow at 1000 ml/min might be seen in hyperemia or certain physiological states but is not the typical baseline.