Exam 1: Anatomy

Due to the site of the tumor, which of the following functions would be impaired?

A 23-year-old man presented to the office due to left arm pain after a fall. The patient fell from a 3m building, landing on his left arm. He did not sustain a head injury and did not lose consciousness. He has no previous medical or surgical history. Vital signs are within normal limits. On examination, bruising over the lateral left arm, with the inability to extend the left wrist. Radiological imaging shows a midshaft fracture of the left humerus. Which of the following arteries is at risk for injury in this patient?

A 17-year-old boy presented to the office due to left arm numbness. He plays on the baseball team of his school and has been training for the last several weeks. week. He has been complaining of tingling and numbness involving the arm, the forearm, and the hand. Additionally, he complains of pain in the little finger and the hand. The pain is noticed to be exacerbated by overhead activities and throwing the ball. The patient is known to have an extra rib. Physical examination shows the weakness of the intrinsic muscles of the left hand. This patient's presentation is related to which of the following muscles?

A 70-year-old man presented to the clinic with recurrent substernal chest pain. His pain is induced by exercise, relieved with rest. The patient is a known case of diabetes mellitus for 20 years. He is a heavy smoker. His blood pressure is 140/85 mm Hg and his pulse is 76/min. ECG showed old ischemic changes. Myocardial perfusion has been done and revealed ischemia at the anterior surface of the heart, involving the upper part of the interventricular septum. Which of the following coronary arteries is most likely affected in this patient?

A 68-year-old man was evaluated in the emergency department due to right arm weakness that persisted for 30 minutes. The patient has had transient right leg weakness. Medical history is significant for chronic hypertension and diabetes mellitus. The radiological evaluation shows an atherosclerotic plaque in the extracranial segment of the supplying artery. The patient is referred for percutaneous stenting of the lesion, the catheter was inserted in the right common femoral artery where it is advanced to the level of the aortic arch. Which of the following is the pathway of the catheter during the stenting procedure?

A 27-year-old male boxer is being evaluated for loss of consciousness. The patient is sent for a CT scan, which showed epidural hematoma. The patient had an epidural hematoma due to a box he received at the pterion, which caused middle meningeal artery rupture. What is the origin of the middle meningeal artery?

During the evaluation of a patient suspected to have infective endocarditis, he had undergone a transesophageal echocardiogram. Which of the following structures is the closest to the esophagus?

An autopsy is done for an 82-year-old man who has died after having a brainstem stroke. During the autopsy, there is destruction in a group of pigmented neurons in the posterior rostral pons, at the lateral floor of the fourth ventricle. These neurons function to release which of the following compounds?

An 81-year-old man presents to the emergency department due to unbearable chest pain, that started before 30 minutes. The pain started while he was chasing his dog in the neighborhood. He has a history of dyslipidemia and diabetes mellitus. ECG shows ST elevation in leads V3 and V4. Cardiac enzymes are elevated. Cardiac evaluation of this patient would reveal stenosis in which of the following arteries?

A 38-year-old woman presented to the office complaining of walking difficult for the last month. Last month, she had a motor vehicle collision, where her left leg had a puncture injury. Physical examination shows dorsiflexed and everted foot. She can't stand on her tiptoes. Otherwise, neurological examination shows no other deficits. Radiological imaging does not show fractures. This patient would have sensory loss over which of the following areas?

A 62-year-old man arrives to the office with clumsiness in his right arm. A physical examination indicates right arm and leg motor weakness. The patient's speech is slurred, and his right lower face is sagging. When the right arm is passively flexed, there is early resistance followed by a dramatic release of tension as the flexion continues. Which of the following brain structures is most likely to blame for this patient's condition?

A 59-year-old man visits the office to have a facial skin lesion evaluated. The lesion is a mole-like area on the patient's face that has gradually expanded over several months. He claims there is no discomfort or bleeding from the lesion. There is a family history of skin cancer. The presentation depicts the results of the physical examination. Biopsy of the lesion with a local nerve block for anesthesia is planned.  Which of the following injection sites is most likely to provide adequate anesthesia for the procedure?

A 75-year-old woman presented to the office complaining of back pain of 6 months duration. The pain radiates to the thighs bilateral and is provoked by walking. The patient can only walk 3-4 blocks due to the pain. The pain seems to be relieved by leaning forward. She does not have a history of trauma. Physical examination shows a normal motor and sensory examination in the lower limbs bilaterally. This patient's presentation is due to the thickening of which of the following ligaments?

A 51-year-old man is brought to the emergency room with chest discomfort that began 30 minutes before his arrival. His chest pain is accompanied by shortness of breath and nausea. When the patient's symptoms began, he was clearing snow off his driveway. He has a history of high blood pressure and type 2 diabetes. The first ECG demonstrates ST elevation in leads I and aVL. Cardiac enzymes are high. In this patient, an urgent cardiac catheterization will most likely reveal obstruction of which of the following arteries?

A 45-year-old woman is evaluated in the office for painful swelling in the tongue. She does not have any previous medical or surgical history. She had unprotected sexual intercourse in the last month. Physical examination shows swelling on the median sulcus 2-cm anterior to the foramen cecum. The pain from this swelling is mediated by which of the following nerves?

A 32-year-old woman, gravida 2 para 1, at 39 weeks gestation had a normal vaginal delivery of a 4000-g boy. The delivery went normal without any serious complications to the baby. After the delivery, that patient was observed to have vaginal bleeding. On examination, a posterior vaginal laceration in the mucosa and submucosa is noted. Which of the following structures is damaged in this patient?

A 64-year-old woman presented to the emergency department complaining of severe lower back pain. The pain has started 3 weeks ago, but it became more severe during the last day. She does not report any trauma or previous medical or surgical history. During the past day, the pain did not respond to analgesics. On examination, her blood pressure is 130/85 mm Hg and her pulse is 100/min. Back examination shows that the back pain is exacerbated by back flexion and leg raising. Stroking the skin around the anus does not induce anal contraction. Motor and sensory examination are normal. Which of the following nerve roots is most likely to be involved in this patient's condition?

A 78-year-old man presented to the clinic due to a chronic cough of three months duration. The patient notices blood in the cough in the morning. He has smoked 3 packs of cigarettes daily for the past 30years. He drinks two cups of wine daily. On examination, the face is engorged, red, and swollen. Both arms and the neck are swollen, with engorged subcutaneous veins. Which of the following structures is obstructed in this patient?

A 25-year-old man is evaluated in the emergency department after he has sustained a stab in his neck. The patient is distressed, but conscious, oriented, and alert. He has stable vital signs. Physical examination reveals hemiplegia on the right side of the body. In addition, he has lost proprioception and vibration sensation below the C8 on the right side. Additionally, he has lost pain and temperature sensation below T2 level on the left side. Radiological imaging of this patient's spine would show the following findings?

A 78-year-old man was brought to the office by his wife due to abnormal involuntary movements of the left arm. While he was walking with his wife, he suddenly through his phone across the street. The patient is known to have hypertension and diabetes mellitus. On examination, he is moving his left arm with large amplitude movements. This patient has a most likely injury in which of the following sites?