Anatomy 🧠

A man aged 35 is troubled by seeing double whenever he gazes to the right. However, his vision returns to normal upon closing either of his eyes. Which nerve is MOST likely affected in this scenario?

A 34 year old gentleman reports to the Accident & Emergency (A&E) following a grievous injury. He had an altercation outside a tavern and was stabbed in his right groin area. He has a clear past medical history and doesn’t take any regular medications. After stabilising the patient, a lower limb neurologic assessment was conducted. This highlighted 4/5 strength during extension of his right knee. The examination also indicated a loss of sensation along the medial side of his right thigh and the anteromedial side of his right calf. Which nerve is the SINGLE most likely one injured in this individual?

While conducting a laparoscopy, a surgeon needs to insert a port. Which anatomical structures would be punctured during the insertion of this port at the halfway mark between the umbilicus and the anterior superior iliac spine?

A man of 36 years is scheduled for surgery to try and remove a glioma. What is the SINGLE anatomical structure that is most likely to be opened during this operation?

A university student seeks help from his GP, complaining about his hand not functioning properly after a rugby match over the weekend. The student doesn’t remember getting injured during the game, but afterwards, he found he had trouble gripping items with his right hand. Upon examination, you note that he’s unable to flex the distal phalanx of his right ring finger. Which is the SINGLE most likely structure affected?

A 39-year-old man has a non-healing ulcer on the skin of his right medial malleolus. Which SINGLE lymph node is likely to be involved?

A 26-year-old patient was lying down on the operating table in a position with his arms hanging down for 3 hours. Soon after waking up, he complains of numbness and weakness in his left hand, accompanied by a wrist drop. There is a loss of sensation over a small area between the dorsal aspect of the 1st and 2nd metacarpals. What is the SINGLE most likely structure to be damaged?

A pregnant woman aged 33, in her third trimester, visits the GP surgery with complaints of numbness and tingling over her left little finger and half of the ring finger. This has been slowly worsening over the months. She has had no injury to her arm or hand. There is no muscle weakness noted on examination. Which nerve is likely compressed?

A man of 57 with rheumatoid arthritis hit his hand against a door. Upon examination, he was able to extend the interphalangeal joint of his right thumb, but the metacarpophalangeal joint of the thumb remained flexed. What is the SINGLE most likely tendon to have been damaged?

A 52-year-old woman has been experiencing a range of symptoms over the past few days. She’s dealing with a generalised headache and, upon further inquiry, mentions blurred vision and pain in her left eye. When looking straight ahead, the left eye appears to have deviated downward and outward. There’s noticeable drooping of her left upper lid, and the pupil is dilated and unresponsive to light. Where is the lesion most likely located?

What significant anatomical point is situated at the 5th intercostal space, anterior to the mid-axillary line?

A 67-year-old woman has been diagnosed with carcinoma of the left ovary. Which group of lymph nodes is most likely to be involved?

A 57-year-old gentleman presents with a scrotal ulcer. What is the SINGLE most likely lymph node involved in its lymphatic drainage?

A gentleman of 53 years comes to your clinic complaining of neck discomfort, left arm unease and weakness in his left hand. The neck pain initiated approximately 5 months prior, followed by the arm unease a month later and shortly thereafter, the hand weakness ensued. The patient mentions the hand weakness is intensifying, hampering his work as a factory labourer. Reflexes in his right arm appear normal. Through manual muscle testing, it is discovered that he has weakness when closing and opening the fingers of his left hand. An MRI scan is carried out, revealing a disc protrusion on the left side at one point in the spinal cord, and a fragment in a foramen at a different level. Which nerve root is likely being pinched by this fragment?

You are supervising a medical student conducting a neurological assessment on a patient. The student neglects to check the reflexes, prompting you to test their understanding of neuroanatomy. Which of the following reflexes is correctly matched with its corresponding innervating spinal nerves?

A 77-year-old lady was brought to the same-day ophthalmology clinic by her general practitioner due to a sudden painless loss of vision in her right eye that has persisted for four hours. Her medical history includes hypertension and extensive smoking. Ophthalmic examination revealed that her right eye could only perceive light, while her left eye had a 6/9 visual acuity. Except for early cataracts, the anterior segment exam was unremarkable. Upon further probing, the patient conceded that she had previously had short episodes of vision loss in the same eye, ranging from a few seconds to minutes. Which artery is most likely implicated in this scenario?

A 34-year-old male involved in a brawl on the street arrives at the Accident and Emergency department with abrasions and a distorted lower right knee. He is administered pain medication and an X-ray is requested. The X-ray reveals a fracture in the neck of the fibula. Which nerve injury is most commonly associated with this type of injury?

A 34-year-old woman with type 2 diabetes has recently been experiencing difficulties with tasks like buttoning her shirt, as well as numbness and paraesthesia in her right hand. She works a desk job in a corporate office. Upon examination, there is a loss of sensation to pinprick along the lateral three digits and the lateral half of the ring finger of her right hand. The sensation in her right little finger is normal. She struggles to touch her right thumb to her right little finger. Her right hand appears less full compared to the left one. Which anatomical structure is likely to be affected?

A 60-year-old man came to the Oral and Maxillofacial surgery outpatient clinic for a post-operative check-up. He recently underwent a right submandibular gland excision for sialolithiasis under general anesthesia. He is now complaining of reduced tongue movements. His tongue sensation is normal and intact, but when he protrudes his tongue, it deviates to the right. What nerve is most likely damaged?

A 44-year-old man arrives at the emergency department after being assaulted. He was struck in the right eye with a chair and is now complaining of pain around the eye as well as altered sensation and numbness over his right cheek, lower eyelid, and upper lip. He didn’t lose consciousness. On examination, significant periorbital edema and ecchymosis are evident. Which nerve is most likely injured?

A 32-year-old patient comes to the emergency department with a deep cut on her palm and the back of her wrist. She can’t extend the distal phalanx of her ring finger. Which structure is most likely affected?

A 59-year-old man with known lung cancer comes to see his general practitioner (GP) complaining of a hoarse voice. He was diagnosed with lung cancer two months ago and is currently receiving chemotherapy. He also reports that the cough he initially presented with has not improved since starting treatment. The patient appears thin and reports weight loss over the past month. A blood test reveals a hemoglobin level of 11.2 g/dL (normal range for males: 13.0-18.0 g/dL; females: 11.5-16.0 g/dL). Which nerve is most likely causing this patient’s hoarseness?

A 64-year-old woman is experiencing difficulty in moving her right shoulder after undergoing surgery in the posterior triangle of her neck. Which of the following anatomical structures is MOST LIKELY to be affected?

A 55-year-old gentleman visits his local doctor complaining of a band of diminished sensation running down the inner and back side of his lower left forearm extending to his little finger. The sensation he describes is a persistent tingling, likened to perpetual “pins and needles” in his left hand. Upon examination, the doctor notices a weakness in thumb extension and wrist deviation towards the ulnar side. There’s also slight atrophy of the muscles in the left hand. Which structure is most likely to be affected here?

A 50-year-old man with a previously diagnosed posterior gastric ulcer comes in reporting severe pain which eases after receiving pain relief. After 8 days, he starts feeling unwell, presenting a fever of 38.5°C. A build-up in the peritoneum is suspected. Where is the most probable location of this build-up?

A 45-year-old man arrives at the Emergency Department after being assaulted in the street, which involved being stabbed in the back of the neck with a knife and repeatedly kicked in his face and neck while he was down. He has an open injury on the left side of the back of his neck, with minimal blood loss. Upon examination, an uneven rise and fall of his chest while breathing is observed. He also has noticeable stridor. Which nerve is most likely to be damaged?

A 35-year-old man sustained a right wrist injury in a road traffic accident a year prior. He experiences loss of feeling over the skin on the palm side of the index finger, thumb, middle finger, and part of the ring finger. There’s evident atrophy of the thenar eminence on his right hand. He finds himself unable to touch his right little finger with his right thumb. Which nerve is most likely affected?

A 52-year-old man visits his GP clinic complaining of neck pain, discomfort in his right arm, and weakness in his right hand. The neck pain started about five weeks ago and the hand weakness manifested a few weeks thereafter. He experiences a tingling sensation on the inner aspect of his right upper arm, coupled with weakness in the abduction and adduction of the fingers of the same arm. A neck X-ray reveals degenerative changes in his cervical vertebrae. Which nerve root is most likely impacted?

A 25-year-old man is experiencing speech difficulties following a stab wound to the right side of his neck. Upon performing a tongue protrusion test, it’s observed that the tip of his tongue veers to the right. Which nerve is most likely affected in this patient?

A 23-year-old woman experiences diminished taste sensation and reduced salivation 24 hours after undergoing a tympanoplasty. What is the most likely nerve to be affected?

A 26-year-old man experiences a baton hit just above his right knee, leading to a loss of leg motor control. His foot is in a dropped position and he is unable to dorsiflex it. There’s also a loss of sensation on the front and the outer half of the leg and on the foot’s upper surface. What is the single most likely anatomical structure that’s affected?

A 7-year-old boy was bicycling when he rode over a rough patch of tar and abruptly fell off. His right leg was struck on the lateral side just above the knee. During a clinical examination, it was found that he was unable to dorsiflex his right foot. Which nerve is most likely involved in this case?

Which anatomical marker or structure is situated slightly above the center point of the inguinal ligament?

A 36-year-old male is suffering from lower back pain that radiates down his right leg. The pain started five days ago after a weightlifting session at the fitness center. He has a weakness in the dorsiflexion of his right foot’s toes. His knee and ankle jerk reflexes are intact. There’s a decrease in sensory input on the top of his right foot. Which nerve root is most likely involved?

A 57-year-old man who had a stroke about a year ago is having extreme trouble remembering events from his past. This includes significant memories like the year he got married. He exhibits changed sexual behavior after the stroke, and long-term memory impairment. He also developed a vision problem after the stroke. What is the most likely vision defect?

A 35-year-old male has experienced a mandibular fracture and now exhibits loss of sensation on his chin and the mucous surface of his lower lip. What SINGLE nerve is most likely implicated in this case?

A 67-year-old man has been experiencing muscle rigidity and tremors over the past few months. Recently, he’s been quite depressed and has discontinued his medication for Parkinson’s disease. Upon examination, he displays a shuffling gait and bradykinesia. Which anatomical structure is likely implicated?

A 24-year-old man fell off a ladder, impacting his shoulder and arm. He’s experiencing weakness in the abduction and external rotation of his right shoulder. His forearm and hand muscles, however, show normal strength. He reports numbness along the outer portion of his arm and forearm. Which structure is most likely affected?

A 44-year-old man visits the clinic with herpes zoster affecting the dermatome of the maxillary branch of the trigeminal nerve. Which SINGLE type of mucosa will also be impacted along with the dermatome?

Which blood vessel descends into the anterior interventricular sulcus?

A 42-year-old man struggles to straighten his right ring and fifth fingers. The condition has been worsening over several months. A hard nodule can be felt on the distal palmar crease, aligning with the ring finger. His father had a similar condition. What is the underlying mechanism of this condition?

A 65-year-old woman with a BMI of 34 has noticeable pigmentation on her legs. Enlarged veins can be seen on the side of her ankle. Which SINGLE structure is likely involved?

A 60-year-old man underwent leg surgery for varicose veins. He now reports feeling numbness on the inner side of his foot. What is the SINGLE most likely nerve involved?

A 68-year-old woman is unable to extend the interphalangeal joint of her right thumb six weeks after fracturing her right radius. Her other fingers and thumb movements are unaffected. Which tendon is most likely to be damaged?

A 37-year-old gentleman found himself unable to raise his left foot and experienced a loss of sensation between his big toe and second toe after sitting in a cross-legged position for half an hour. What is the SINGLE most likely anatomical structure affected?

A 30-year-old man who was playing handball had his left shoulder dislocated after being hit from behind. He’s experiencing difficulty in lifting his left arm and lost sensation around the skin over the deltoid. What is the SINGLE most likely nerve that’s affected?

What SINGLE anatomical landmark aligns with the tip of the 9th costal cartilage?

A 34-year-old man rushes into the Emergency Department after a fracture-dislocation of his right elbow. He reports loss of sensation in his little finger and ring finger. Which is the SINGLE most likely nerve to be involved?

A 48-year-old gentleman is receiving treatment for a pleural effusion. A chest drain was placed just under the 4th rib, anterior to the mid-axillary line on his right side. Which SINGLE structure has a significant risk of being injured?

What is the most probable anatomical feature that would be penetrated when placing a drain along the mid-axillary line?

A 35-year-old male is experiencing lower back pain that radiates down his right leg. The pain started two days ago when he was lifting heavy boxes. His knee and ankle reflexes are normal. However, he has decreased sensation on the top of his right foot. Which nerve root is most likely impacted?

During a laparoscopic cholecystectomy, which anatomical structure(s) are initially penetrated when a port is inserted halfway between the anterior midline and the mid-axillary line?

A 62-year-old man was affixing a cupboard to the wall when he suddenly experienced a tearing sensation in the cubital fossa, resulting in elbow swelling and weakness during flexion and supination. A lump is visible in the lower arm. What is the most probable diagnosis?

A 75-year-old woman with rheumatoid arthritis fell and now cannot extend the fingers of her right hand at the metacarpophalangeal and interphalangeal joints. Which tendon is most likely to be injured?

A 66-year-old construction worker was putting up shelves when he suddenly experienced a sharp ripping feeling in the cubital fossa, followed by swelling at the front of the elbow. His arm is extremely sensitive to touch. What is the most probable diagnosis?

Where does the lymphatic drainage of the testes occur?

A 64-year-old man visits his primary care doctor with complaints of double vision when descending stairs. What is the most likely nerve involved in this case?

A 35-year-old man reports that his right eye is deviating outward and drooping. He also experiences double vision. Which nerve is most likely affected in this case?

A 47-year-old man has been diagnosed with cancer of the posterior oropharynx. Which lymph node is most likely to be affected?

A 14-year-old boy comes in with a swollen and painful knee after a sudden fall on his right knee. The pain is concentrated around the kneecap and there is localized swelling over the patella. Which SINGLE anatomical structure is most likely involved?

A 33-year-old woman with a known history of gallstones underwent a cholecystectomy. Unfortunately, she continues to experience pain, and her liver function tests suggest obstructive jaundice. An ERCP reveals a calculus lodged in the second part of the duodenum. What is the SINGLE most likely location where the stone was lodged?

A man who rides camels experienced an injury to the lateral side of his right leg just above the knee, due to being hit by a camel stick. The area is slightly bruised and sensitive to touch. He is unable to dorsiflex or evert his foot, and has lost sensation over the front and outer half of his leg, as well as the dorsum of his foot. What is the SINGLE most likely anatomical structure affected?

Which landmark or anatomical structure is located at the midpoint between the suprastemal notch and pubic symphysis?

A man aged 33 has noticed a white patch on the middle section of his tongue. What is the MOST likely lymph node that could be affected?

Following an elbow injury, a 47-year-old man experiences a loss of sensation on both the dorsal and plantar surfaces of the ulnar edge of his right hand. His hand has assumed a “claw-like” posture. Which motion, when tested against resistance, would confirm injury to the implicated nerve?

A 17-year-old boy reports experiencing double vision while descending the stairs. This started after he sustained a blow to his face. The images he perceives are vertically arranged, and he also notices the double vision when he looks to his right. Which nerve is MOST likely compromised in this case?

A 35-year-old woman suffered injuries to her thigh and groin area due to a seatbelt during a car accident. Since the incident, she’s been experiencing decreased sensation and a slight burning feeling on the lateral part of her left thigh. Which nerve is MOST likely impacted in this case?

A 34-year-old man has reported experiencing pain on the inside of his left forearm. He also mentioned noticeable weakness in the abduction and adduction of his fingers, as well as in the adduction of his thumb. Finger flexion appeared to be normal. Upon visual inspection, muscle atrophy in his left hand was observed. What is the SINGLE most likely associated injury?

A 32-year-old man is experiencing double vision when he looks to his left. However, his vision returns to normal when either his right or left eye is closed. Which nerve is MOST likely involved in this case?

A 35-year-old man is experiencing double vision, facial discomfort, and pain in his right ear. The double vision worsens when he looks to his right. He struggles with outward eye movement on his right side. There’s also a discharge from his right ear. Which nerve is MOST likely implicated in this case?

A 47-year-old man was struck in the back with a chair during a fight. He presents with back pain and visible bruising. The pain specifically occurs at the midpoint of his spine, aligned with the level of the iliac crest. Which vertebra is MOST likely to be affected?

A 74-year-old woman experienced a stroke one month ago. Since then, she has suffered from paralysis in her left upper and lower limbs and has difficulty speaking. Which anatomical site is MOST likely to be affected?

A 47-year-old man has been informed by his doctors that he has carcinoma of the head of the pancreas. Which SINGLE structure is in close proximity to the head of the pancreas?

A 65-year-old woman arrives at the Emergency Department with an inability to flex the proximal interphalangeal (PIP) joint of her left hand. She discloses that she broke a wine glass, resulting in a cut on the surface of her left hand. She has not undergone any previous hand procedures. During the examination, a clean 2x2cm cut is observed on her left hand. Wrist joint extension, as well as hand adduction and abduction, are normal. However, she is unable to flex her first metacarpophalangeal (MCP) joint. An X-ray of the left hand shows no abnormalities. Which structure is MOST likely injured in her case?

Which of the following is positioned at the level of the first lumbar vertebra (L1)?

A 35-year-old man experienced a fall while working as a window cleaner approximately 6 months ago. He recollects grabbing onto a ledge with his outstretched left arm during the descent, resulting in a fracture of his left elbow and shoulder injury. Surgical management was performed, and his arm is currently immobilized in a sling. Subsequently, he has been experiencing reduced sensation in his little finger. Upon examination, atrophy of the interosseous muscles is observed. The patient also exhibits loss of sensation in the little finger and the medial half of the ring finger. In terms of motor function assessment, he is unable to cross the two fingers or abduct his little finger. Which of the following structures is MOST likely to be damaged?

A 33-year-old man underwent ankle ligament reconstruction due to an ankle injury and resulting ankle instability. Following the procedure, he was placed in a below-knee cast that extended to the top of the foot for several weeks. Upon removal of the cast, he experienced an inability to dorsiflex his foot for a few days. What is the MOST likely diagnosis?

A 32-year-old man visits the clinic with complaints of right shoulder pain and difficulty raising his right hand above his shoulder. He cannot recall a specific time of injury but mentions that his shoulder has been feeling unusual lately. Despite this, he has continued his weight training program. Seeking help as the condition did not improve, he noticed that his shoulder blade appeared to protrude in an abnormal manner when observing his upper back in the mirror. During the physical examination, increased pain is noted when he raises his right arm and tilts his head to the left. Scapula winging is observed when he elevates his arm, which becomes more prominent when he pushes against a wall with his arms extended. Which nerve is likely affected?

A 75-year-old man presents to the GP surgery with frequent pain in the calf muscle of his left leg. He reports that the pain starts after a few steps and worsens with continued walking. His symptoms began approximately two months ago and have progressively worsened; currently, he can only walk a distance of 50 meters before needing to rest. The patient has a history of diabetes mellitus, but he is non-compliant with his medication. He is also a heavy smoker with a history of 40 pack-years. On examination, the popliteal and pedal pulses in the left leg are not palpable, but the femoral pulse is palpable. Which of the following is the most likely site of arterial obstruction?