12. Subacromial bursitis
A patient presents with severe pain over the lateral shoulder. The pain is particularly noticeable during abduction, and imaging demonstrates inflammation of a bursa beneath the acromion. Which structure is primarily involved?
A) Subscapular bursa
B) Infraspinatus muscle
C) Glenohumeral joint cavity
D) Subacromial bursa
E) Teres minor muscle
Answer: D) Subacromial bursa
Short explanation:
Subacromial/subdeltoid bursitis produces localized shoulder pain. The subacromial bursa is closely related to the supraspinatus tendon and lies beneath the acromion.
A patient presents with severe pain over the lateral shoulder. The pain is particularly noticeable during abduction, and imaging demonstrates inflammation of a bursa beneath the acromion. Which structure is primarily involved?
A) Subscapular bursa
B) Infraspinatus muscle
C) Glenohumeral joint cavity
D) Subacromial bursa
E) Teres minor muscle
Answer: D) Subacromial bursa
Short explanation:
Subacromial/subdeltoid bursitis produces localized shoulder pain. The subacromial bursa is closely related to the supraspinatus tendon and lies beneath the acromion.
13. Suprascapular notch
During surgery near the superior border of the scapula, a surgeon identifies the suprascapular notch. Which structure normally passes under the superior transverse scapular ligament?
A) Suprascapular artery
B) Suprascapular nerve
C) Circumflex scapular artery
D) Axillary nerve
E) Dorsal scapular artery
Answer: B) Suprascapular nerve
Short explanation:
A classic anatomical relationship is:
Suprascapular artery → over the ligament
Suprascapular nerve → under the ligament
The nerve then supplies supraspinatus and continues toward infraspinatus.
During surgery near the superior border of the scapula, a surgeon identifies the suprascapular notch. Which structure normally passes under the superior transverse scapular ligament?
A) Suprascapular artery
B) Suprascapular nerve
C) Circumflex scapular artery
D) Axillary nerve
E) Dorsal scapular artery
Answer: B) Suprascapular nerve
Short explanation:
A classic anatomical relationship is:
Suprascapular artery → over the ligament
Suprascapular nerve → under the ligament
The nerve then supplies supraspinatus and continues toward infraspinatus.
14. Thoracic outlet syndrome
A patient with a cervical rib develops paresthesia involving the medial forearm and hand, weakness of intrinsic hand muscles, and changes in the radial pulse. Which part of the brachial plexus is most likely compressed?
A) Upper trunk
B) Middle trunk
C) Lower trunk
D) Lateral cord
E) Posterior cord
Answer: C) Lower trunk
Short explanation:
Thoracic outlet syndrome can result from a cervical rib. Neurological symptoms involving the medial forearm and hand with intrinsic hand weakness point toward C8–T1, which form the lower trunk. Vascular compression may also alter the radial pulse
A patient with a cervical rib develops paresthesia involving the medial forearm and hand, weakness of intrinsic hand muscles, and changes in the radial pulse. Which part of the brachial plexus is most likely compressed?
A) Upper trunk
B) Middle trunk
C) Lower trunk
D) Lateral cord
E) Posterior cord
Answer: C) Lower trunk
Short explanation:
Thoracic outlet syndrome can result from a cervical rib. Neurological symptoms involving the medial forearm and hand with intrinsic hand weakness point toward C8–T1, which form the lower trunk. Vascular compression may also alter the radial pulse
15. Brachioradialis reflex
A patient has an absent brachioradialis reflex after a cervical nerve injury. Which spinal nerve is primarily responsible for this reflex?
A) C5
B) C6
C) C7
D) C8
E) T1
Answer: B) C6
Short explanation:
The brachioradialis reflex is primarily mediated by C6. In comparison, the biceps reflex mainly involves C5–C6, while the triceps reflex is mainly C7.
A patient has an absent brachioradialis reflex after a cervical nerve injury. Which spinal nerve is primarily responsible for this reflex?
A) C5
B) C6
C) C7
D) C8
E) T1
Answer: B) C6
Short explanation:
The brachioradialis reflex is primarily mediated by C6. In comparison, the biceps reflex mainly involves C5–C6, while the triceps reflex is mainly C7.
16. Volkmann ischemic contracture
A child sustains a supracondylar fracture of the humerus. Several hours later, increasing swelling and ischemic changes develop in the forearm. Injury to which vessel is most directly responsible for this complication?
A) Axillary artery
B) Radial artery
C) Brachial artery
D) Ulnar artery
E) Profunda brachii artery
Answer: C) Brachial artery
Short explanation:
A supracondylar fracture may injure the brachial artery, producing bleeding and increased pressure within the flexor compartment. Reduced arterial perfusion can result in Volkmann ischemic contracture
A child sustains a supracondylar fracture of the humerus. Several hours later, increasing swelling and ischemic changes develop in the forearm. Injury to which vessel is most directly responsible for this complication?
A) Axillary artery
B) Radial artery
C) Brachial artery
D) Ulnar artery
E) Profunda brachii artery
Answer: C) Brachial artery
Short explanation:
A supracondylar fracture may injure the brachial artery, producing bleeding and increased pressure within the flexor compartment. Reduced arterial perfusion can result in Volkmann ischemic contracture
17. Long head of biceps brachii
A professional athlete develops a sudden bulge in the anterior arm after an injury to the long head of biceps brachii tendon. Which clinical sign is characteristic?
A) Froment sign
B) Winging of scapula
C) Popeye sign
D) Wrist drop
E) Ape hand
Answer: C) Popeye sign
Short explanation:
The tendon of the long head of biceps brachii runs through the intertubercular groove before attaching to the supraglenoid tubercle. Rupture can cause distal retraction of the muscle, producing the characteristic Popeye sign.
A professional athlete develops a sudden bulge in the anterior arm after an injury to the long head of biceps brachii tendon. Which clinical sign is characteristic?
A) Froment sign
B) Winging of scapula
C) Popeye sign
D) Wrist drop
E) Ape hand
Answer: C) Popeye sign
Short explanation:
The tendon of the long head of biceps brachii runs through the intertubercular groove before attaching to the supraglenoid tubercle. Rupture can cause distal retraction of the muscle, producing the characteristic Popeye sign.
18. Median nerve injury in the forearm
A penetrating injury damages the median nerve as it enters the forearm. When the patient's hand is relaxed, which deformity is most likely to develop?
A) Extension of the MCP and IP joints of digits 2 and 3
B) Flexion of the MCP and IP joints of digits 2 and 3
C) Abduction of digits 4 and 5
D) Extension of the thumb with loss of opposition
E) Flexion of the DIP joints of digits 4 and 5
Answer: A) Extension of the MCP and IP joints of digits 2 and 3
Short explanation:
A proximal median nerve injury paralyzes most of the long flexors supplied by the median nerve. The unopposed radial nerve extensors therefore produce an extended posture of the lateral digits.
A penetrating injury damages the median nerve as it enters the forearm. When the patient's hand is relaxed, which deformity is most likely to develop?
A) Extension of the MCP and IP joints of digits 2 and 3
B) Flexion of the MCP and IP joints of digits 2 and 3
C) Abduction of digits 4 and 5
D) Extension of the thumb with loss of opposition
E) Flexion of the DIP joints of digits 4 and 5
Answer: A) Extension of the MCP and IP joints of digits 2 and 3
Short explanation:
A proximal median nerve injury paralyzes most of the long flexors supplied by the median nerve. The unopposed radial nerve extensors therefore produce an extended posture of the lateral digits.
19. Common flexor sheath
A penetrating infection enters the flexor sheath of the little finger. If untreated, into which space can the infection most readily spread?
A) Thenar space
B) Hypothenar compartment
C) Midpalmar space
D) Central compartment
E) Dorsal subcutaneous space
Answer: C) Midpalmar space
Short explanation:
The flexor sheath of the little finger is continuous proximally with the midpalmar space. Infection can therefore spread from the fifth digit into this space.
A penetrating infection enters the flexor sheath of the little finger. If untreated, into which space can the infection most readily spread?
A) Thenar space
B) Hypothenar compartment
C) Midpalmar space
D) Central compartment
E) Dorsal subcutaneous space
Answer: C) Midpalmar space
Short explanation:
The flexor sheath of the little finger is continuous proximally with the midpalmar space. Infection can therefore spread from the fifth digit into this space.
20. Mallet finger
A baseball player sustains an injury resulting in permanent flexion of the distal interphalangeal (DIP) joint of a finger. Which structure has most likely been damaged?
A) Flexor digitorum profundus tendon
B) Flexor digitorum superficialis tendon
C) Extensor tendon insertion at the distal phalanx
D) Central slip of extensor tendon
E) Lumbrical muscle
Answer: C) Extensor tendon insertion at the distal phalanx
Short explanation:
Mallet finger (baseball finger) results from avulsion of the extensor tendon insertion at the distal phalanx, causing loss of active DIP extension and a flexed DIP posture.
A baseball player sustains an injury resulting in permanent flexion of the distal interphalangeal (DIP) joint of a finger. Which structure has most likely been damaged?
A) Flexor digitorum profundus tendon
B) Flexor digitorum superficialis tendon
C) Extensor tendon insertion at the distal phalanx
D) Central slip of extensor tendon
E) Lumbrical muscle
Answer: C) Extensor tendon insertion at the distal phalanx
Short explanation:
Mallet finger (baseball finger) results from avulsion of the extensor tendon insertion at the distal phalanx, causing loss of active DIP extension and a flexed DIP posture.
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أجمعوا الاسئلة وياريت ترسلوها لي عشان اعرف مدى مستوى الامتحان.
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كسرة لناس دفعة 2024 ، مراجعة الفسيولوجي ح تكون مساء غداً السبت ( 7:45 مساءً) بإذن الله..
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CHOOSE THE BEST ANSWER ONLY
1. A patient loses 2 L of isotonic fluid due to severe diarrhea. Which of the following changes occurs immediately?
A. ↓ Plasma osmolarity, ↓ ECF volume, ↑ ICF volume
B. ↑ Plasma osmolarity, ↓ ECF volume, ↓ ICF volume
C. No change in plasma osmolarity, ↓ ECF volume, no change in ICF volume
D. ↑ Plasma osmolarity, ↑ ICF volume
2. Which fluid compartment contains the greatest proportion of body water?
A. Plasma
B. Interstitial fluid
C. Intracellular fluid
D. Transcellular fluid
3. Edema is LEAST likely to occur with:
A. Increased capillary hydrostatic pressure
B. Increased plasma protein concentration
C. Lymphatic obstruction
D. Increased capillary permeability
4. A patient has:
Na⁺ = 160 mEq/L
Glucose = 90 mg/dL
BUN = 28 mg/dL
Calculated plasma osmolarity is:
A. 295 mOsm/L
B. 310 mOsm/L
C. 325 mOsm/L
D. 335 mOsm/L
5. Blood volume is 5 L, and hematocrit is 40%. Plasma volume is:
A. 2.0 L
B. 2.5 L
C. 3.0 L
D. 3.5 L
6. A healthy volunteer consumes 250 mL O₂/min. Given 1 L O₂ releases 4.82 kcal, calculate daily BMR:
A. 1600 kcal/day
B. 1735 kcal/day
C. 1850 kcal/day
D. 2000 kcal/day
7. A patient receives a drug that blocks ganglionic nicotinic receptors. Which function is least affected?
A. Heart rate
B. Sweat secretion
C. Skeletal muscle contraction
D. Pupillary diameter
8. Which autonomic neurotransmitter is released directly from postganglionic sympathetic fibers supplying sweat glands?
A. Norepinephrine
B. Dopamine
C. Acetylcholine
D. Epinephrine
9. A patient receives aspirin during fever. The fall in body temperature results primarily from:
A. Reduced metabolic rate
B. Decreased hypothalamic prostaglandin synthesis
C. Increased sympathetic discharge
D. Direct inhibition of shivering
10. A red blood cell is placed in a solution containing 300 mOsm/L urea. What is the immediate outcome?
A. No change in cell volume
B. Cell shrinks permanently
C. Cell swells and may eventually lyse
D. Water leaves the cell continuously
1. A patient loses 2 L of isotonic fluid due to severe diarrhea. Which of the following changes occurs immediately?
A. ↓ Plasma osmolarity, ↓ ECF volume, ↑ ICF volume
B. ↑ Plasma osmolarity, ↓ ECF volume, ↓ ICF volume
C. No change in plasma osmolarity, ↓ ECF volume, no change in ICF volume
D. ↑ Plasma osmolarity, ↑ ICF volume
2. Which fluid compartment contains the greatest proportion of body water?
A. Plasma
B. Interstitial fluid
C. Intracellular fluid
D. Transcellular fluid
3. Edema is LEAST likely to occur with:
A. Increased capillary hydrostatic pressure
B. Increased plasma protein concentration
C. Lymphatic obstruction
D. Increased capillary permeability
4. A patient has:
Na⁺ = 160 mEq/L
Glucose = 90 mg/dL
BUN = 28 mg/dL
Calculated plasma osmolarity is:
A. 295 mOsm/L
B. 310 mOsm/L
C. 325 mOsm/L
D. 335 mOsm/L
5. Blood volume is 5 L, and hematocrit is 40%. Plasma volume is:
A. 2.0 L
B. 2.5 L
C. 3.0 L
D. 3.5 L
6. A healthy volunteer consumes 250 mL O₂/min. Given 1 L O₂ releases 4.82 kcal, calculate daily BMR:
A. 1600 kcal/day
B. 1735 kcal/day
C. 1850 kcal/day
D. 2000 kcal/day
7. A patient receives a drug that blocks ganglionic nicotinic receptors. Which function is least affected?
A. Heart rate
B. Sweat secretion
C. Skeletal muscle contraction
D. Pupillary diameter
8. Which autonomic neurotransmitter is released directly from postganglionic sympathetic fibers supplying sweat glands?
A. Norepinephrine
B. Dopamine
C. Acetylcholine
D. Epinephrine
9. A patient receives aspirin during fever. The fall in body temperature results primarily from:
A. Reduced metabolic rate
B. Decreased hypothalamic prostaglandin synthesis
C. Increased sympathetic discharge
D. Direct inhibition of shivering
10. A red blood cell is placed in a solution containing 300 mOsm/L urea. What is the immediate outcome?
A. No change in cell volume
B. Cell shrinks permanently
C. Cell swells and may eventually lyse
D. Water leaves the cell continuously
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