Anatomic Sciences 1-50 (lymphatic S blood urinary sys joints foramen resp sys arteries).txt

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Anatomic Sciences 1-50 (lymphatic S blood urinary sys joints foramen resp sys arteries).txt
2015-08-13 15:47:09
Anatomic Sciences

Anatomic Sciences
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  1. Which of the following structures carry lymph (fluid) into the node's sub-capsular sinus, through the cortical sinus and into the superficial cortex and paracortex?

    a) Efferent lymphatic vessels
    b) Afferent lymphatic vessels
    c) Both afferent and efferent
    d) Neither afferent nor efferent
    • Afferent lymphatic vessels carry lymph into the node's subcapsular sinus, through the cortical sinus and into the superficial cortex and paracortex.
    • There are fewer efferent than afferent vessels
    • Paracortex is dominated by T-cells
  2. All of the following structures are primarily comprised of lymphoid tissue (presence of lymphocytes) except one.

    a) Spleen
    b) Liver
    c) Tonsils
    d) Thymus
    e) MALT
    • Liver
    • Principal structures of the lymphatic system are the tonsils, bone marrow, spleen, thymus, lymph nodes, lymph, lymphatic vessels, and the appendix.
    • Areas of diffuse lymphoid tissue MALT, GALT, BALT, mucosa-gut-bronchus associated lymphoid tissue.
  3. Immunocompetent T-cells primarily develop in which structure?

    a) Spleen
    b) Bone Marrow
    c) Thymus
    d) Lymph Nodes
    • Thymus: is a bi-lobed lymphoid organ, does not contain lymph nodules or vessels. Main function is to potentiate immunocompetent T-cells from their precursors. Self recognizing T-cells are destroyed in the Thymus. Thymus is large in newborns and grows until puberty where it goes thru involution, being replaced by adipose tissue. In adults, its blood supply is isolated, not so much in children.
    • Spleen is the largest single mass of lymphoid tissue in the body, located in the left hypochondriac region of the abdominal cavity. Can be considered 2 organs in one because it filters blood and makes antibodies and lymphocytes.
    • Bone Marrow contains pluripotent stem cells which can become Lymphocytes or Phagocytes
  4. Which of the following lymph node groups extend from the base of the skull to the root of the neck?

    a) Facial Nodes
    b) Occipital Nodes
    c) Deep cervical nodes
    d) Jugulodigastric nodes
    • Deep Cervical nodes, located along the length of the internal jugular vein deep to the sternocleidomastoid muscle (divides superior and inferior) on each side of the neck. 
    • Responsible for drainage of most of the circular chain of nodes, receives direct efferents from salivary and thyroid glands, tongue, tonsils, nose, pharynx and larynx. All of these join to form the Jugular Lymph Trunk. This vessel drains either the thoracic duct (on the left) or the right lymphatic duct (on the right).
    • Other regional lymph nodes; Parotid lymph nodes, submandibular lymph nodes, submental lymph nodes.
  5. When antigen recognition occurs by a lymphocyte, B-cells are activated and migrate to which area of the lymph node?
    a) Inner medullary region
    b) Medullary cords
    c) Medullary sinuses
    e) Germinal centers
    • Germinal centers
    • The node consists of superficial (cortical region) that contains separate masses of lymphoid tissue called lymphoid follicles. Primary follicles do not respond to antigens and stain uniformly. Secondary follicles contain lightly staining germinal centers that active follicles responding to antigens.
    • Lymph nodes are small dilations of lymphatic tissue enclosed in a fibrous capsule with internal trabeculae supporting tissues and sinuses. They act as filters that remove and destroy antigens with macrophages. They also produce  antibodies and store lymphocytes.
    • They are divided into PRIMARY and SECONDARY
  6. The thoracic duct usually drains into the:

    a) Left internal jugular vein
    b) Left subclavian vein
    c) Junction of the left internal jugular and subclavian veins
    d) Superior vena cava
    e) Junction of the right internal jugular and subclavian veins
    Junction of the left internal jugular and subclavian vein. The thoracic duct is the main duct of the lymphatic system located in the posterior mediastinum. Begins in the abdomen Cisterna Chyli (at T12) and ascends in front of the spinal column. It is the common trunk of all the lymphatic vessels in the body and drains the majority of them (more than the right lymphatic duct, which collects from upper right quadrant and empties into right venous angle)
  7. A 25 year old car accident victim is brought into the emergency room complaining of severe abdominal pain radiating into the left scapula. Low hematocrit, marked hypotension, and a grossly bloody peritoneal tap all indicate a ruptured spleen. A Splenectomy will be performed, and the surgeon must remove the spleen from the:

    a) Right inguial region
    b) Right hypochondrium region
    c) Left hypochondrium region
    d) Hypogastrium
    • Left hypochondrium region, is the location of the spleen, a ovoid organ the size of a fist containing white and red pulp. Develops from mesnchymal cells. White pulp contains masses of lymphocytes surrounding the branches of the splenic artery and the red consists of a network of blood filled sinusoids. Possesses only efferent lymphatic vessels. Blood enters Splenic artery, exits splenic vein.
    • 3 different tissues; Reticuloendothelial tissue (phagocytosis of cell debris from blood), Venous sinusoids (method of expelling blood to meet increased circulatory demands), White pulp (lymphocytes, antibodies)
  8. An 11 year old girl presents to the pediatrician with high fever, sore throat, earache, and greenish sputum. Enlarged tonsils, areas of pus, and the inflammation indicate tonsillitis. The girl is also breathing through her mouth; the swelling of which tonsils caused the obstruction of the nasopharyngeal isthmus?

    a) Lingual tonsils
    b) Palatine tonsils
    c) Pharyngeal tonsils
    • Pharyngeal tonsils are part of the secondary immune system, they are involved in the production of mostly secretory IgA, which provides immune protection. When a sufficient antigen is present the B-cells become active in the germinal zone of the lymphoid follicle to produce antibodies.
    • Pharyngeal tonsils located in posterior wall of nasopharynx also called adenoids. Contain NO CRYPTS. Ciliated pseudo stratified columnar epithelium.
    • Palatine Tonsils, one on each side of posterior lateral side of the throat. Big during childhood, diminish after puberty, Many crypts, no sinuses. Non-keratinized stratified squamous epithelium.
    • Lingual tonsils, smaller, more numerous. Posterior portion of the dorsum of the tongue, each has a single crypt. non-keratinized stratified squamous epithelium.
  9. In which of the following locations would one most likely find yellow bone marrow in an adult?

    a) Diaphysis of femur
    b) Epiphysis of humerus
    c) Ribs
    d) Cranial bones
    e) Vertebrae
    • Diaphysis of femur (long shaft of bone known as medullar cavity), yellow marrow appears at the age of 7 distally and moves proximally only leaving...
    • Cavities in cranial bones, vertebrae, ribs, sternum and ends of long bones contain Red bone marrow (blood forming tissue erythrocytes leukocytes and thrombocytes in process called hemopoiesis)
    • Red marrow contains precursos cells called hemocytoblasts (multipotent), which form proerythroblasts and megakaryocytes
  10. Which leukocyte is the predominan cell type in pus, and is known as the hallmark of the acute inflammation because of its fast immune response?

    a) Basophil
    b) Eosinophil
    c) Monocyte
    d) Lymphocyte
    e) Neutrophil
    Neutrophils (most present for phagocytosis)
  11. Which of the following statements is NOT true regarding erythrocytes? They:

    a) Are biconcave in shape
    b) Have an average lifespan of 30 days
    c) Have no nucleus
    d) Are disposed of by the spleen
    • They do not Have an average lifespan of 30 days. The kidney produces the hormone for their production which is called erythropoiesis, for their lifespan of 120 days.
    • Principal function is to transport oxygen and CO2, hemoglobin combines to oxygen and CO2 to form oxyhemoglobin and carbaminohemoglobin.
    • Proportion of erythrocytes in a sample of blood is called Hematocrit 46% for males, 40% for females.
  12. Which Leukocytes are the least abundant?

    a) Neutrophils
    b) Monocytes
    c) Eosinophils
    d) Basophils
    e) Lymphocytes
    • Basophils are the least abundant
    • Never Let Monkeys Eat Bananas, is the order!
    • Blood is 55% plasma, 45% formed elements, pH is 7.35-7.45, temp 38C, 4-6 Liters, 8% of body weight.
  13. Guillain-Barre symdrome, myasthenia gravis, Wegener's granulomatosis, and Goodpasture syndrome all include plasmapheresis as a treatment option. After separating whole blood from plasma, the plasma is returned into circulation. Which of the following would be returned as a normal component of plasma?

    a) Formed elements
    b) Agranulocytes
    c) Thrombocytes
    d) CFC
    e) Albumin
    • Albumin is 55% of plasma, Globulins are 38%, and Fibrinogen 7%. Plasma is also 91% water.
    • Serum = blood plasma without fibrinogen (precursor to fibrin + Factor XIII, a factor in clotting)
  14. Platelets are best described as:

    a) Megakaryocytes
    b) Cytoplasmic fragments
    c) Agranulocytes
    d) Immature leukocytes
    e) Lymphoid cells
    Cytoplasmic fragments. Although platelets are classified as blood cells, platelets are actually fragments of large bone marrow cells called Megakaryocytes. Lifespan of 7-10, removed by Spleen and Liver. They stop blood loss with the Platelet Plug.
  15. A 61-year-old male comes into the family physician complaining of sharp aches and burning sensation in his hips and knees. The pain gradually gets worse throughout the day, and although the knees seem enlarged, there is minimal inflammation. The physician notes slight grating and crackling sounds (crepitus) and diagnoses osteoarthritis. The cause of the signs and symptoms of osteoarthritis is the degradation of which of the following structures in load bearing joints.

    a) Meniscus
    b) Synovial membrane
    c) Bursa
    d) Articular cartilage
    • Articular cartilage
    • Bursa is a fluid-sac that is lined with synovial membrane, purpose is to reduce friction.
    • Synovial joints are characterized by 4 features:
    • -Articular cartilage - thin layer of hyaline cartilage that covers the smooth articular bone surfaces. This layer contains no blood vessels or nerves (TMJ contains fibrocartilage, NOT HYALINE CARTILAGE)
    • -Joint cavity - small fluid filled space separating ends of adjoining bones
    • -Articular (joint) capsule - double-layered; outer layer of fibrous connective tissue that encloses the joint.
    • -Synovial membrane - produces synovial fluid. Found on both Bursa and articular cartilage.
  16. An 18-month old boy diagnosed with Crouzon's syndrome needs to have surgery to treat the prematurely fused cranial bones. The joints in the flat bones of the fused cranium are classified as which of the following. 

    a) Sutures
    b) Symphyses
    c) Synchondroses
    d) Syndesmoses
    • Sutures 
    • Joints are classified as
    • Fibrous Joints - Sutures (nonmovable), Syndesmoses
    • Cartilaginous joints - Synchondroses, symphyses
    • Sinovial Joints (free movement): Gliding, Hunge, Pivot, Saddle and Ball and socket.
  17. The paramedics arrive at the scene of a minor motor vehicle collision. One driver claims to have experienced whiplash and is having trouble shaking her head in a "NO" motion. She is fine with nodding her head in a "YES" manner. Which of the following joints allows maximum rotational movement of the head about its vertical axis (SAYING NO)

    a) Intervertebral joint
    b) Atlantoaxial joint
    c) Atlanto-occipital joint
    d) Costovertebral joint
    • Atlantoaxial joint
    • The atlanto-occipital joint permits rocking or nodding movements of the head as in saying "yes". This joint is the synovial articulation between the superior articulating facets of the atlas (first cervical vertebra) and the occipital condyles of the skull.
  18. 51 year old male telemarketer has had a history of nephrolithiasis (kidney stones). A calcium oxalate buildup in the renal papilla would directly block filtrate flow into the:

    a) Major Calyx
    b) Renal columns
    c) Minor Calyx
    d) Ureter
    e) Renal pyramid
    • Minor Calyx
    • Kidneys have 2 functions: form urine and homeostasis. Right kidney is lower because of liver lobe. Receives blood from renal artery. Hilum is indentation on medial border.
    • Internal features of kidney: 
    • - Cortex - outer light brown layer, site of blood filtration
    • - Medulla - inner dark brown layer, contains cone line structures called renal pyramids separated by Renal columns (extensions of renal cortex).
    • - Renal pelvis - hollow inner structure that joints with ureters (tubes that conduct urine to bladder). Receives urine through the calyces.
    • - Renal papilla - apex of pyramids, here the collecting ducts pour into minor calyces
    • - Renal Calyx - extension of the renal pelvis. Minor calyces unite to form major calyces, which urine is emptied into.
  19. Name the following structures of the nephron in the order they are encountered from blood to urine.

    a) Distal convoluted tubule
    b) Bowman's capsule
    c) Collecting duct
    d) Glomerulus
    e) Loop of Henle
    f) Proximal convoluted tubule
    • Glomerulus
    • Bowman's Capsule
    • Proximal convoluted tubule
    • Loop of Henle
    • Distal convoluted tubule
    • Collecting duct
    • Components of the nephron are Renal Corpuscle (Glomerulus and Bowman's Capsule) and Tubular Portion (Proximal convoluted tube, loop of Henle, distal convoluted tube, collecting duct)
  20. After passing through the renal pelvis, urine directly flows through which structure?

    a) Renal papilla
    b) Urethra
    c) Ureter
    d) Major Calices
    e) Urinary bladder
  21. 26 year-old female has been previously diagnosed with McCune-Albright syndrome. There is bony fibrous dysplasia of the anterior cranial base leading to the encasement and narrowing of the optic canal. Although her vision is normal, there is a concern that there will be compression of the optic nerve and which of the following other structures?

    a) Ophthalmic nerve (CN V-1)
    b) Cranial nerves III, IV and VI
    c) Ophthalmic artery
    d) Ophthalmic veins
    Ophthalmic artery - The optic canal is located posteriorly in the lesser wing of the sphenoid. It communicates with the middle cranial fossa. It transmites the optic nerve and ophthalmic artery.
  22. Which of the following joints is/are a synarthrosis?

    a) TMJ
    b) Skull sutures
    c) Synovial joints
    d) Condyloid joints
    Skull Sutures

    • 3 main classifications of articulations based on the amount of motion they allow
    • Synarthosis - immovable joint (sutures skull)
    • Amphiarthrosis - Slightly movable (symphysis pubic)
    • Diarthrosis - freely movable (synovial joint)

    They can also be classified by type of associated connective tissue FIBROUS, CARTILAGINOUS or SYNOVIAL
  23. a 62 year-old female visits the family physicial with complaints of right-sided hearing loss, ringing in the right ear (tinnitus), numbness over the right half of her face, and dizziness. The physician diagnoses her with an acoustic schwannoma that is occluding her right internal acoustic meatus. The internal acoustic meatus pierces the posterior surface of the petrous part of the temporal bone. The internal acoustic meatus transmits which two structures?

    a) Trigeminal nerve (CNV) and Facial (CNVII)
    b) Facial (CNVII) and Vestibulocochlear (CNVIII)
    c) Vestibulocochlear (CNVIII) and Vagus (CNX)
    d) Trigeminal (CNV) and Vagus (CNX)
    • Facial (CNVII) and Vestibulocochlear (CNVIII). The vestibulocochlear enters the internal acoustic meatus and remains within the temporal bone, to the cochlear duct (hearing), semicircular ducts and maculae (balance). The facial nerve enters the acoustic meatus, the facial canal in the temporal bone, and emerges from the stylomastoid foramen. The stylomastoid foramen lies between the styloid and mastoid processes of the temporal bone.
    • Main trunk of facial nerve exits stylomastoid foramen
  24. A fourth-year dental student is performing operative work on a mandibular molar. He is read to provide an inferior alveolar nerve block. Thinking of his old anatomy exams, he reminds himself that this nerve enters the mandibular foramen. In relationship to the occlusal plane of the mandibular molars, the mandibular foramen is located:

    a) At or slightly above the occlusal plane and anterior to the molars
    b) At or slightly below the occlusal plane and anterior to the molars
    c) At or slightly below the occlusal plane and posterior to the molars
    d) At or slightly above the occlusal plane and posterior to the molars
    • At or slightly above the occlusal plane and posterior to the molars. It is located on the medial surface of the ramus of the mandibule just below the lingula (attachment for sphenomandibular ligament).
    • The IAN divides into mental nerve and incisive branch.
  25. Which of the following allows for the exit of the spinal accessory nerve from the cranial cavity?

    a) Foramen magnum
    b) Jugular foramen
    c) Foramen Rotundum
    d) Foramen ovale
    Jugular foramen, lies between the lower border of the petrous part of the temporal bone and the condylar part of the occipital bone. It transmites internal jugular vein, glossopharyngeal, vagus and spinal accessory nerves.
  26. Cranial nerves that supply motor innervation to the muscles that move the eyeball all enter the orbit through the:

    a) Supraorbital foramen
    b) Superior orbital fissure
    c) Infraorbital Foramen
    d) Petrotympanic fissure
    e) Optic canal
    • Superior orbital fissure, is located posteriorly between the greater and lesser wings of the sphenoid bone, and communicates with the middle cranial fossa.
    • Transmits ...Superior and inferior divisions of oculomotor nerve CNIII, Trochlear nerve CNIV, lacrimal, frontal and nasociliary branches of the ophthalmic nerve (CNV-1), abducent nerve CNVI), superior and inferior divisions of the ophthalmic vein, sympathetic fibers from the cavernous plexus.
  27. During a baseball game, a collision between the catcher and the runner into home plate resulted in fractures of the catchers ribs, leading to a pneumothorax of the left lung. A pneumothorax is the presence of the air into which space?

    a) Pericardial sac
    b) Hilum
    c) Pleural cavity
    d) Mediastinum
    e) Peritoneum
    • Pleural Cavity, Pneymothorax is air in the pleural cavity, hemothorax is blood inside, in both situations the surface tension that binds the lung to the chest wall is eliminated and lung shrinks to size of a tennis ball.
    • Right lung 3 lobes, 10 bronchial segments receives 1 bronchial artery
    • Left lung 2 lobes, 8 bronchial segments, 2 bronchial arteries, cardiac notch and lingula.
  28. The trachea bifurcates into the right and left primary bronchi at the level of the:

    a) First rib
    b) Seventh cervical vertebra
    c) Xiphoid process
    d) Plane of the sternal angle
    e) Suprasternal (or jugular) notch
    • Plane of the sternal angle. The trachea connects the upper respiratory tract to the lower. Located in front of the esophagus and behind the thyroid gland. It bi-furcates into the right and left main stem bronchus at a location called Carina, located at the level of the sternal angle (T4-T5).
    • The right main bronchus divides into 3 bronchi and the left into 2 bronchi, one for each lobe of the lung.
  29. Emphysema is a pulmonary disease of the lung characterized by destruction of the supporting structures of the alveoli. This leads to decreased elasticity of lung tissue. In which structure will gaseous exchange first occur?

    a) Tertiary bronchioles
    b) Primary bronchioles
    c) Alveolar ducts
    d) Respiratory bronchioles
    e) Terminal bronchioles
    • Respiratory Bronchioles, continue from terminal bronchioles, branch nearer to the alveolar ducts and sacs and have occasional alveoli in their walls. These bronchioles capable of respiring are the 1st gen of the passageways of the respiratory portion of the bronchial tree.
    • Conducting bronchioles are smaller extensions of bronchi, the last generations of conducting bronchioles are called terminal bronchioles
    • Bronchioles are characterized by... diameter (1mm), epithelium ciliated pseudostrat to simple cub. Small Bronchioles have non-ciliated bronchiolar epithelial cells. Walls devoid of glands in underlying connective tissue, Walls devoid of cartilage.
  30. A clumsy dentist, while placing a crown, accidentally drops it into the patients mouth. The patient aspirates the crown. A chest x-ray will most likely reveal the crown lodged in the:

    a) Trachea
    b) Right primary bronchus
    c) Left Primary bronchus
    d) Pulmonary artery
    e) Pulmonary vein
    • Right primary bronchus is larger, straighter and shorter than the left. It is also more in line with the trachea.
    • Root of the lung contains... Primary bronchus (right and left bronchi arise from trachea), Pulmonary artery (carries oxygen poor blood), Pulmonary veins carry oxygen rich blood
    • Branches of the vagus nerve pass behind the root of each lung to form the posterior pulmonary plexus
  31. The lungs can be found in which body space?

    a) Middle mediastinum
    b) Anterior mediastinum
    c) Pleural cavities
    d) Peritoneal cavity
    • Pleural Cavities. The thoracic cavity is subdivided into the pleural cavities (each containing a lung) and the mediastinum ( the middle mediastinum contains the heart and pericardial sac)
    • Respiratory system consists of upper and lower respiratory tracts, the lungsm and the thoracic cage.
    • Upper resp. is nose, mouth, nasopharynx, oropharynx, laryngopharynx and larynx.
    • Lower resp. is trachea, bronchi and lungs.
  32. Which type of epithelium provides sensory innervation that travels on nerve bundles through the cribiform plate?

    a) olfactory epithelium
    b) respiratory epithelium
    c) transitional epithelium
    d) junctional epithelium
    Olfactory epithelium (specialized columnar epithelium). Air enters through nostrils, bony roof of nasal cavity is formed by the cribiform plate of the etmoid bone. Lateral walls have projections called Conchae (sup, mid, inf)
  33. White descending to 30,000 feet, the passengers on a comercial flight experience the sensation of their ears "popping". The swallowing or yawning that triggers this equalizes the pressure of the middle ear with the surrounding atmosphere via the eustachian (auditory) tube. The pharyngeal opening for this tube, along with the salpingopharyngeal fold. pharyngeal recess, and pharyngeal tonsils (adenoids) are all located in the:

    a) Laryngopharynx
    b) Oropharynx
    c) Nasopharynx
    d) None of the above
    • Pharynx (the throat) is the tube that serves as the passageway for the respiratory and digestive tracts. It is divided into 3 regions
    • Nasopharynx is the most superior, inferior to the sphenoid bone (at the level of soft palate), has 4 openings (2 auditory tubes connect w middle ear and 2 posterior nares). Tensor veli palatino and levator veli palatini prevent food from entering.
    • Oropharynx is the middle division of the pharynx, lingual tonsils protrude into oropharynx. Anterolateral walls support the palatine tonsils. Food and air passageway.
    • Laryngopharynx is the most inferior, extends from hyoid bone to the opening of the esophagus. Passageway for food and air, food going into esophagus and air into larynx (food into larynx is expelled by violent coughing)
  34. A newborn in Ethiopia, whos mother has a human papillomavirus infection, starts to grow warts on her larynx and respiratory tract. A tracheotomy is performed in order to allow her to breathe. Which of the following structures is not at risk during the procedure?

    a) Recurrent laryngeal branch of the vagus nerve
    b) Carotid artery
    c) internal jugular vein
    d) vocal chords
    e) thyroid gland
    • Vocal chords are above the incision area for tracheotomies and cricothyrotomies (preferable to a tracheotomy to non-surgeons in emergency respiratory obstructions. Incision made through skin and cricothyroid membrane (cricothyroid space) for relief of obstruction.
    • Emergency tracheotomy is most easily made by incision through the median cricothyroid ligament.
  35. The external carotid artery terminates within the parotid gland, just behind the neck of the mandibule, where the external carotid artery gives off two final branches. Which of the following is one of those terminal branches?

    a) Superior thyroid artery
    b) superficial temporal artery
    c) posterior articular artery
    d) occipital artery
    e) facial artery
    • Superficial temporal artery
    • Branches of external carotid are
    • Superior thyroid artery
    • Lingual artery
    • Facial artery
    • Ascending pharyngeal artery
    • Occipital artery
    • Posterior auricular artery
    • Maxillary artery - final branch
    • Superficial temporal artery - final branch
  36. A chiropractor performing a spinal adjustment quickly moved his patients head from rest to the left. She immediately reported hemiplegia (paralysis of half of her body) - and slurred speech. At the hospital, it was discovered that therapy caused an embolus to develop into a stroke. The clot arose from an antherosclerotic plaque located at the bifurcation of the common carotid artery. At what level does the common carotid artery bifurcate?

    a) Cricoid cartilage
    b) Angle of the mandibule
    c) Jugular notch
    d) Superior border of the thyroid cartilage
    • Superior border of the thyroid cartilage
    • 4 major arteries supply the brain w oxygenated blood (two vertebral and two carotid)
    • Circle of Willis formed by the posterior cerebral, posterior communicating, internal carotid, anterior cerebral and anterior communicating
  37. In carotid sinus syncope, the carotid sinus is overly sensitive to manual stimulation and can lead to loss of consciousness, Given this, which of the following statements is true?

    a) It is stimulated by changes in blood pressure
    b) It functions as a chemoreceptor
    c) It is innervated by the facial nerve
    d) It is located at the terminal end of the external carotid artery
    e) It communicated freely with the cavernous sinus
    • It is stimulated by changes in blood pressure. Changes in blood pressure stimulate vagal nerve endings in the wall of the carotid sinus send signals along the vagus nerve to slow the heart rate "Carotid Sinus Reflex"
    • Carotid sinus is innervated by the carotid sinus branch of the glossopharyngeal nerve and by a brand of the Vagus CNX
    • Carotid body lies posterior to the bifurcation of the common carotid (innervated same as sinus) and is a chemoreceptor, sensitive to excess CO2 (rises BP)
  38. Which of the following branches of the internal carotid artery is the most frequently implicated in a stroke?

    a) Ophthalmic artery
    b) Anterior choroidal
    c) Middle cerebral
    d) Anterior Chorodial
    Middle cerebral artery is the largest branch of the internal carotid, supplies frontal lobe and lateral portion of surface of temporal and parietal lobes, primary motor and sensory areas of face. Small deep penetrating arteries known as lenticulostriate arteries are called "arteries of stroke".
  39. All of the following statements are true regarding hepatic sinusoids in comparison to capillaries EXCEPT one, Which one is the EXCEPTION?

    a) Sinusoids are smaller in diameter than capillaries
    b) Sinusoids have walls that consist party of phagocytic cells
    c) Sinusoids are a part of the reticuloendothelial system
    d) Both sinusoids and capillaries are composed of endothelium.
    • Sinusoids are smaller in diameter than capillaries, sinusoids are small blood vessels similar to capillary but with discontinuous endothelium. Found in liver, lymphoid tissue, endocrine organs and hematopoietic organs such as bone marrow and the spleen.
    • Sinusoids are highly permeable, wider and irregular, walls are phagocytic, walls are reticuloendothelial system.
  40. The most prominent functional component in the tunica media of large arteries is the:

    a) Skeletal muscle cells
    b) Elastic fibers
    c) Smooth muscle cells
    d) collagen fibers
    • Elastic fibers is the answer. walls of blood vessels are composed of the following tunics (layers)
    • Tunica intima - innermost layer, present in vessels of all sizes, Antherosclerosis is plaque between basement membrane of the endothelial cells of the tunica intima.
    • Tunica media - middle layer, tick in arteries, smooth muscle fibers mixed w elastic, changes in diameter, affects blood pressure.
    • Tunica Adventitia - outer layer of connective tissue, containing elastic and collagenous fibers. In larger vessels is infiltrated w tiny vessels called Vasa Vasorum that nourish the external wall.
  41. The tunica media and adventitia are absent in which blood vessel type?

    a) Arteries 
    b) Arterioles
    c) Capillaries
    d) Venules
    e) Veins
    Capillaries are tiny blood vessels with extremely thin walls of endothelium no tunica media or adventitia. They join Arterioles and venules. They accommodate erythrocytes one at a time.
  42. Which artery supplies the liver with oxygenated blood?

    a) Common carotid artery
    b) Portal artery
    c) Hepatic Artery
    d) Splanchnic artery
    • Hepatic Artery, arises from the common hepatic, which, in turn, is a branch of the celiac trunk. All of the blood supplied to the liver from the hepatic arteries and the portal vein eventually drains via the hepatic veins to the inferior vena cava.
    • All blood supplied to liver from hepatic artery and portal vein empties into the same sinusoids, which causes a mixture of arterial and venous blood. Sinusoids of each lobule empty into common central vein which then goes to back to the heart.
  43. The greatest drop in blood pressure is seen at the transition from:

    a) Arterioles to capillaries
    b) Arteries to arterioles
    c) Capillaries to venules
    d) Venules to vein
    Arteries to arterioles experience the biggest drop in blood pressure. Highest pressure is found in arteries and gradually drops as blood flows through arterioles, capillaries, venules and veins (where it is the lowest)
  44. The submandibular gland receives its principal arterial supply via which artery?

    a) Lingual
    b) Sublingual
    c) Inferior alveolar
    d) Facial
    • Facial artery supplies blood to the face, tonsils, palate, labial glands and muscles of the lips. Also supplies the submandibular gland, the ala and dorsum of the nose and muscles of facial expression. BRANCHES ARE
    • Cervical (tonsular, ascending palatine (base of skull, pharynx), submental (salivary glands)
    • Facial (Inferior labial, superior labial, lateral nasal, angular (medial side of the eye and can anastamose with dorsal nasal branch of ophthalmic artery.
    • Terminal branches of external carotid are Superficial temporal artery and maxillary artery
  45. Which artery does not accompany the corresponding nerve throughout its course?

    a) Inferior alveolar artery
    b) Posterior superior alveolar artery
    c) Lingual artery
    d) Infraorbital artery
    • Lingual artery arises from the surface of the external carotid artery, Supplies blood to the tongue, supra-hyoid region, sublingual gland, palatine tonsils and the floor of the mouth.
    • Usually found between the hyoglossus and genioglossus muscles.
    • The IA vein, artery and nerve alone w the lingual nerve are together in between the media pterygoid muscle and ramus of the mandible (pterygomandibular space)
  46. In the E.R., a car accident victim who hit his face on the steering wheel arrives bleeding profusely from the mouth and nose. Upon the examination, the physical discovers that along with avulsed teeth, his hard palate is fractured and the incisive foramen is obliterated. Which artery emerges from the incisive foramen.

    a) Greater palatine artery
    b) Descending palatine artery
    c) Nasopalatine artery
    d) Lesser palatine artery
    Nasopalatine artery. The maxillary artery ends by becoming the sphenopalatine artery, which supplies the nasal cavity, The sphenopalatine artery gives rise to the posterior lateral nasal branches and septal branches, including nasopalatine branch that accompanies the nasopalatine nerve through the incisive foramen on the maxilla.
  47. Examination of a patient with an ulcerative carcinoma of the posterior third of the tongue revealed bleeding from the lesion and difficulty swallowing (dysphagia). The bleeding was seen to be arterial; which of the following arteries was involved?

    a) Deep lingual artery
    b) Dorsal lingual artery
    c) Tonsillar artery
    d) Sublingual artery
    • Dorsal lingual artery runs on the superficial surface of the tongue, it is a branch of the lingual artery that delivers blood to the posterior superficial tongue. So this one of the source for hemorrhage.
    • Lingual artery (from external carotid) branches are 
    • Dorsal lingual: base and body of tongue
    • Suprahyoid: muscles of the same name
    • Sublingual: mylohyoid muscle, sublingual salivary gland and mucosa of membranes of the floor of the mouth
    • Deep lingual: supplies apex of the tongue
  48. What branch of the maxillary artery runs through the foramen spinosum and is implicated in epidural hematomas?

    a) inferior alveolar artery
    b) Middle meningeal artery
    c) infraorbital artery
    d) deep temporal artery
    Middle meningeal artery
  49. After a large thanksgiving dinner, the traditional american family notices that they are all drowsy "the food coma" is a result of oxygenated blood being restricted from the brain and being shunted to the stomach in order for digestion. All of the arteries that supply stomach are derived directly or indirectly from the:

    a) Splenic artery
    b) Hepatic artery
    c) Gastroduodenal artery
    d) Celiac trunk
    Celiac trunk. All of the arteries that supply the stomach are derived directly or indirectly from the celiac trunk. The celiac artery takes its origin from the abdominal aorta just below the diaphragm at the T12. Has 3 terminal branches Splenic artery, Left gastric artery and Common hepatic artery
  50. The internal thoracic artery ends in the sixth intercostal space by dividing into the:

    a) Anterior and posterior intercostal arteries
    b) Subclavian and inferior epigastric arteries
    c) Superior epigastric and musculophrenic arteries
    Superior epigastric and musculophrenic arteries. The internal thoracic, supplies the anterior wall of the body form the clavicule to the umbilicus. It is a branch of the first part of the subclavian artery in the neck, This artery decends and ends in the sixth intercostal space by dividing into superior epigastric and musculophrenic arteries.