Lippincott's Illustrated Q&A Review of Anatomy and Embryology

242 Pages·2010·13.63 MB·English

by  H. Wayne Lambert

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Acquisitions Editor: Crystal Taylor
Product Managers: Kelley A. Squazzo & Catherine A. Noonan
Designer: Doug Smock
Compositor: SPi Technologies
First Edition
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Library of Congress Cataloging-in-Publication Data
Lambert, Harold Wayne, 1972–
Lippincott’s illustrated Q&A review of anatomy and embryology / H. Wayne Lambert, Lawrence E. Wineski ; with special contribu-
tions from Jeffery P. Hogg, Pat Abramson, Bruce Palmer. — 1st ed.
p. ; cm.
Includes index.
ISBN 978-1-60547-315-4
1. Human anatomy—Examinations, questions, etc. I. Wineski, Lawrence E. II. Title.
[DNLM: 1. Anatomy—Examination Questions. 2. Embryology—Examination Questions. QS 18.2 L222L 2011]
QM31.L36 2011
611.0076—dc22
2010008648
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Dedication
This book is dedicated to our students who make our jobs enjoyable
each and every year, our mentors who trained us and still serve as our role models,
and our families for their constant support and patience.
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Preface
Lippincott’s Illustrated Q&A Review of Anatomy and Embryology presents essential concepts of gross anatomy and
embryology in a question-and-explanation format. This textbook will enable students to identify and clarify spe-
cifi c, high-yield information frequently tested in anatomy and embryology courses and board examinations. There-
fore, this book is benefi cial to professional students in the fi elds of allopathic, osteopathic, dental, and podiatric
medicine. It is designed to prepare these students for course examinations and the Gross Anatomy and Embryology
Subject Examination given by the National Board of Medical Examiners as well as prepare students for professional
board examinations, such as the Step/Part 1 of the United States Medical Licensing Examination, the Comprehensive
Osteopathic Medical Licensing Examination, the National Board Dental Examination, and the National Board of
Podiatric Medical Examination.
All of the 424 clinical vignette-style questions located within the Lippincott’s Illustrated Q&A Review of Anatomy
and Embryology textbook are written such that one best answer is required. Detailed explanations of both the correct
and incorrect answers are included to highlight frequently tested material, key concepts, and mnemonics to facilitate
retention of information. Working through this textbook will help students develop their knowledge base, problem-
solving skills, and integration of important clinical concepts. Because professional courses and board examinations
often require interpretation of illustrations, over 200 high-quality photographs and line drawings are included within
many of the questions. These illustrations portray clinical signs and symptoms, summarize information, and expose
students to current radiologic imaging techniques, such as magnetic resonance imaging, computed tomography, and
basic X-ray (or plain) fi lms. For students taking medical, dental, podiatric, and allied health courses, the use of this
review book and the online testing site will facilitate classroom learning and self-assessment in the fi elds of anatomy
and embryology.
H. Wayne Lambert
Lawrence E. Wineski
iv
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Acknowledgments
We thank our many colleagues who have contributed to the development and completion of this textbook, whether
they are aware of their contributions or not. We greatly appreciate the time, thought, ideas, critical review, support,
mentoring, and encouragement from the following individuals.
Dr. Anne M. R. Agur, Professor in Division of Anatomy, Department of Surgery, Faculty of Medicine, University of
Toronto, Toronto, Ontario, Canada
Dr. Heather J. Billings, Assistant Professor, Department of Neurobiology and Anatomy, West Virginia University
School of Medicine, Morgantown, West Virginia
Dr. Ferrell R. Campbell, Professor, Department of Anatomical Sciences and Neurobiology, University of Louisville
School of Medicine, Louisville, Kentucky
Dr. Arthur F. Dalley II, Professor of Cell and Developmental Biology, Vanderbilt University School of Medicine,
Nashville, Tennessee
Dr. James F. Densler, Adjunct Clinical Associate Professor, Department of Surgery, Morehouse School of Medicine,
Atlanta, Georgia
Dr. Richard D. Dey, Professor and Chair, Department of Neurobiology and Anatomy, West Virginia University School
of Medicine, Morgantown, West Virginia
Mr. Sean Dodson, Third year medical student, West Virginia University School of Medicine, Morgantown,
West Virginia
Dr. Martha L. Elks, Professor and Associate Dean for Medical Education, Morehouse School of Medicine, Atlanta,
Georgia
Dr. Noelle Granger, Professor Emeritus, Department of Cell and Developmental Biology, University of North Carolina
School of Medicine, Chapel Hill, North Carolina
Dr. Herbert C. Jones, Adjunct Clinical Professor, Department of Surgery, Morehouse School of Medicine, Atlanta,
Georgia
Dr. Brian R. MacPherson, Professor, Department of Anatomy and Neurobiology, University of Kentucky College of
Medicine, Lexington, Kentucky
Dr. James A. McCoy, Professor of Clinical Surgery and Director of Surgical Education, Morehouse School of Medicine,
Atlanta, Georgia
Dr. Keith L Moore, Professor Emeritus in Division of Anatomy, Department of Surgery, Faculty of Medicine, University
of Toronto, Toronto, Ontario, Canada
Dr. Peter R. MacLeish, Professor and Chair, Department of Neurobiology, Morehouse School of Medicine, Atlanta,
Georgia
Dr. Douglas F. Paulsen, Professor, Department of Pathology and Anatomy, Morehouse School of Medicine, Atlanta,
Georgia
Dr. Wojciech Pawlina, Professor and Chair, Department of Anatomy, Mayo Medical School, Rochester, Minnesota
Ms. Doris Pitts, Administrative Assistant, Department of Pathology and Anatomy, Morehouse School of Medicine,
Atlanta, Georgia
Dr. Frank D. Reilly, Professor, Department of Neurobiology and Anatomy, West Virginia University School of M edicine,
Morgantown, West Virginia
Dr. Thomas W. Sadler, Consultant, Birth Defects Prevention, Twin Bridges, Madison County, Montana
Dr. Virginia T. Lyons, Associate Professor, Department of Anatomy, Dartmouth Medical School, Hanover,
New Hampshire
Dr. Peter J. Ward, Assistant Professor, Department of Anatomy, West Virginia School of Osteopathic Medicine,
Lewisburg, West Virginia
We also extend our appreciation to the staff at Lippincott Williams & Wilkins for their guidance during the
development of this textbook: Crystal Taylor, Acquisitions Editor; and Kelley Squazzo and Catherine Noonan,
Product Managers.
H. Wayne Lambert
Lawrence E. Wineski
v
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Contents
Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iv
Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Chapter 1 General Principles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Chapter 2 Early Development. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Chapter 3 Thorax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Chapter 4 Abdomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Chapter 5 Pelvis and Perineum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
Chapter 6 Back. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93
Chapter 7 Lower Limb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114
Chapter 8 Upper Limb and Mammary Gland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .140
Chapter 9 Head and Neck. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Chapter 10 Cranial Nerves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .206
Figure Credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .225
Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .229
vi
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Chapter 1
General Principles
QUESTIONS (A) Flexion
(B) Abduction
Select the single best answer. (C) Pronation
(D) Adduction
I. Anatomical Directions and Movements
(E) Supination
1 Which of the following is true of the anatomical position?
(A) The humerus is proximal to the scapula. II. Bones and Joints
(B) The radius is medial to the ulna.
(C) The vertebral arch is ventral to the vertebral body. 6 Bones are often classifi ed according to their shape and/or
developmental pattern. Which of the following choices is an
(D) The femur is superior to the fi bula.
example of a fl at bone?
(E) The phalanges of the foot are cranial to the metatarsals.
(A) Humerus
(B) Sternum
2 If the body were sectioned along a ___ plane, it would be
divided into ___ portions. (C) Hamate
(A) sagittal…anterior and posterior (D) Maxilla
(B) sagittal…superior and inferior (E) Patella
(C) coronal…superior and inferior
7 In endochondral ossifi cation, bone replaces most of an initial
(D) coronal…right and left
cartilage model. Which of the following refers to the part of a
(E) horizontal…superior and inferior
bone ossifi ed from the primary ossifi cation center?
(A) Diaphysis
3 Which of the following is true of a median plane of the hand?
(B) Epiphysis
(A) It becomes a horizontal plane when the hand is medially
(C) Metaphysis
rotated 90 degrees.
(D) Epiphyseal plate
(B) It becomes a coronal plane when the brachium (upper
arm) is laterally rotated 90 degrees and abducted (E) Condyle
90 degrees.
(C) It is the same as a frontal plane. 8 A 16-year-old boy crashes his mountain bike and suffers a
fractured tibia. Which of the following damaged structures
(D) It remains a median plane regardless of limb or body
would most likely produce the acute pain emanating from the
position.
fractured tibia?
(E) It is oriented mediolaterally.
(A) Nerves in compact bone
(B) Nerves in trabecular bone
4 A radiologist wishes to image the body in a plane parallel to
both scapulae. Which of the following choices best describes (C) Surrounding muscle and tendon receptors
the desired sectioning? (D) Periosteal nerves
(A) Horizontal section (E) Vascular nerves
(B) Transverse section
(C) Frontal section 9 Which of the following is an example of a cartilaginous joint?
(D) Sagittal section (A) Humeroulnar joint
(E) Oblique section (B) Middle radioulnar joint
(C) Intervertebral disc joint
5 A young boy uses his right hand to screw-in a new light bulb. (D) Cranial sutural joint
Which of the following terms best describes the screw-home (E) Tibiotalar joint
movement of his forearm?
1
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2 Chapter 1
10 Synovial joints allow free movement between their bony 15 A 17-year-old boy engages in an intensive weight-lifting
elements. They are classifi ed into multiple subtypes accord- program to build muscle strength. The growth of his muscles
ing to the shape of the articulating surfaces and/or the degree is the result of which of the following processes?
of movement allowed. Which of the following synovial joint (A) Atrophy
types permits multiaxial movement? (B) Hypertrophy
(A) Pivot (C) Hyperplasia
(B) Ball and socket (D) Tonus
(C) Condyloid (E) Shunting
(D) Saddle
(E) Hinge 16 During an exercise program, a physical therapist instructs
her patient to fl ex his elbow. Which of the following terms
describes the muscles that perform that desired action?
11 In examining a radiograph of the right shoulder of a 32-year-old
(A) Agonists
male car accident victim, the radiologist identifi es the head of
the humerus located below the coracoid process of the scapula (B) Antagonists
in a subcoracoid position. Which of the following terms best (C) Fixators
describes the condition of the humerus? (D) Proprioceptors
(A) Avulsed (E) Synergists
(B) Comminuted
(C) Dislocated IV. Nervous System
(D) Reduced
17 Which of the following structures are innervated by somatic
(E) Subluxated
motor neurons?
(A) Meissner corpuscles
III. Integument, Fascia, and Muscle (B) Arrector pili muscles of hair follicles
(C) Myocardium of the left ventricle
12 A physician delivers an intramuscular injection into the lat- (D) Wall of the axillary artery
eral aspect of the shoulder. Which of the following sequences (E) Semispinalis muscle
describes the correct order of tissue layers pierced by the nee-
dle, passing from superfi cial to deep? 18 A 55-year-old woman presents with ulceration and pain in the
(A) Epidermis, dermis, superfi cial fascia, epimysium, deep skin around and including her right nipple. Her physician cor-
fascia rectly identifi es the affected area as that of the T4 dermatome.
(B) Dermis, epidermis, superfi cial fascia, deep fascia, epimy- The pain this woman is suffering could be related to which of
sium the following spinal segmental levels?
(C) Dermis, epidermis, superfi cial fascia, epimysium, deep (A) T3 only
fascia (B) T4 only
(D) Epidermis, dermis, superfi cial fascia, deep fascia, epimy- (C) T3 and T4
sium (D) T4 and T5
(E) Epidermis, superfi cial fascia, dermis, deep fascia, epimy- (E) T3, T4, and T5
sium
19 A man exhibits anhydrosis (lack of sweating) and erythema
(fl ushing) on his chest due to loss of sympathetic innervation.
13 A 20-year-old college student on spring break suffers a fi rst-
A thorough neurological analysis reveals dysfunction of pre-
degree sunburn on her back and upper limbs. Which of the
synaptic (preganglionic) sympathetic nerve cell bodies. Which
following integumentary structures/functions is most likely
of the following sites is most likely damaged in this patient?
affected?
(A) Brainstem
(A) Hair follicles
(B) Lateral gray horn of the spinal cord
(B) Subcutaneous fat
(C) Sympathetic chain ganglia
(C) Vitamin A production
(D) Prevertebral ganglia
(D) Parasympathetic nerve endings
(E) Dorsal root ganglia
(E) General sensory nerve endings
20 A research scientist at a pharmaceutical company discovers a
14 A teenage boy breaks a pane of glass with his fi st and receives new drug that selectively blocks the release of norepinephrine
a laceration to the posterior aspect of his wrist. He notices the from nerve endings. At which of the following sites would this
tendons that cross his wrist lift out of place (or bowstring) drug have the greatest effect on normal synaptic transmission?
when he extends his wrist. Which of the following structures (A) Somatic neuron motor end plates
was most likely cut by the broken glass? (B) Postsynaptic parasympathetic nerve terminals
(A) Investing deep fascia (C) Postsynaptic sympathetic nerve terminals
(B) Intermuscular septum (D) Synapses between presynaptic and postsynaptic para-
(C) Bursa sympathetic neurons
(D) Retinaculum (E) Synapses between presynaptic and postsynaptic sympa-
(E) Synovial tendon sheath thetic neurons
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