Krok 1 – 2014 Base(Anatomy)

A patient has a right-sided fracture in the region of the frontal third of mandible accompanied by a haematoma in the region of chin. It is caused by the injury of the following artery:

Children often have heavy nasal breathing resulting from excessive development of lymphoid tissue of pharyngeal mucous membrane. What tonsils growth may cause this effect?

In course of laparotomy a surgeon revealed gangrenous lesion of descending colon. It was caused by thrombosis of the following artery:

As a result of a cold a patient has the abnormal pain and temperature sensitivity of the frontal 2/3 of his tongue. Which nerve must have been damaged?

A patient with a stab wound of the anterior stomach wall is in surgical care. What formation of abdominal cavity did the stomach contents get into?

A patient has tissue ischemia below the knee joint accompanied with intermittent claudication. What artery occlusion should be suspected?

After a trauma of soft tissues in the region of the posterior sorface of medial condyle of humerus a patient has got a skin prickle of medial forearm surface. Which of the listed nerves is located in the affected region?

A female patient with a tumour of pancreas has developed mechanic jaundice resulting from compression of a bile-excreting duct. Which duct is compressed?

A 28 year old woman has been diagnosed with extrauterine pregnancy complicated by the fallopian tube rupture. The blood is most likely to penetrate the following peritoneal space:

Examination of a 2-year-old child revealed physical developmental lag, the child often has  pneumonias. The child was diagnosed with nonclosure of ductus arteriosus. Haemodynamics  disorder was caused by the intercommunication of the following vessels:

Inflammation of the tympanic cavity (purulent otitis media) was complicated by inflammation of  mammillary process sockets. What wall of tympanic cavity did the pus penetrate into the sockets through?

It is necessary to take the cerebrospinal fluid from a patient with suspected inflammation of brain tunics. Diagnostic puncture was performed between the arches of the lumbar vertebras. During the puncture the needle went through the following ligament:

Nowadays about 50 minor bases have been found in the t-RNA structure besides the main four nitrogenous bases. Choose the minor nitrogenous base:

A patient operated on complicated appendicitis has the following changes of blood count:
erythrocytes – 4,0*1012/l, Нb – 120 g/l, color index – 0,9, leukocytes – 18*109/l, basophils – 0, eosinophils – 0, myelocytes – 0, juvenile – 0, stab neutrophils – 20, segmentonuclear neutrophils – 53, lymphocytes – 21, monocytes – 5. How is such nuclear shift of leukocytic formula called?

An old woman was hospitalized with acute pain, edema in the right hip joint; the movements in the joint are limited. Which bone or part of it was broken?

A 53-year-old female patient was diagnosed with liver rupture resulting from a blunt abdominal injury. The escaped blood will be assembled in the following anatomic formation:

A patient complains about edemata of legs, skin cyanosis, small ulcers on one side of the lateral condyle. Examination revealed a swelling, enlarged veins, formation of nodes. The pathological process has started in the following vein:

A 70 year old female patient was diagnosed with fracture of left femoral neck accompanied by disruption of ligament of head of femur. The branch of the following artery is damaged:

A woman underwent an operation on account of extrauterine (tubal) pregnancy. In course of the operation the surgeon should ligate the branches of the following arteries:

A 6 month old baby ill with bronchitis was taken for an X-ray of chest. Apart of changes associated with bronchi the X-ray film showed a shadow of thymus gland. What might have caused such changes?

A patient suffering from chronic myeloleukemia has got the following symptoms of anemia: decreased number of erythrocytes and low haemoglobin concentration, oxyphilic and polychromatophilic normocytes, microcytes. What is the leading pathogenetic mechanism of anemia development?

A 7-year-old girl has signs of anemia. Laboratory examination revealed pyruvate kinase deficiency in erythrocytes. What process disturbance plays the main role in anemia development?

A patient complained about being unable to adduct and abduct fingers in the metacarpophalangeal articulations towards and away from the 3rd finger. Which muscles’ function is impaired?

While examining foot blood supply a doctor checks the pulsation of a large artery running in the separate fibrous channel in front of articulatio talocruralis between the tendons of long extensor muscles of hallux and toes. What artery is it?

Microspecimen of spinal cord contains a nucleus that should be analyzed. Its neurons form motor endings in the skeletal muscles. What nucleus of spinal cord is meant?

A man with cut wound of his right foot sole was admitted to the hospital ward. The patient has limited elevation of the lateral foot edge. In course of wound management the injury of a muscle tendon was revealed. What muscle is injured?

A comminuted fracture of infraglenoid tubercle caused by shoulder joint injury has been detected during X-ray examination of a patient. What muscle tendon attached at this site has been damaged?

A 35 year old man with a trauma of his left hand was admitted to the traumatology department. Objectively: cut wound of palmar surface of left hand; middle phalanxes of II–V fingers don’t bend. What muscles are damaged?

A 38-year-old patient came to a traumatology centre and complained about an injury of his right hand. Objectively: the patient has a cut wound in the region of the thenar eminence on the right hand; distal phalanx of the I finger cannot be flexed. What muscle was injured?

A patient with neuritis of femoral nerve has disturbed flexion of thigh as well as disturbed crus extension in the knee joint. What muscle’s function is disturbed?

A 42-year-old male with a lesion of the ulnar nerve is unable to flex the II and V fingers to the midline. Which muscle function is impaired in this case?

A patient has difficulties with hand movement. Examination revealed inflammation of common synovial sheath of flexor muscles. It is known from the patient’s anamnesis that he got a stab wound of finger a week ago. Which finger was most probably damaged?

An injured man has bleeding from branches of carotid artery. For a temporary arrest of bleeding it is necessary to press the carotid artery to the tubercle of a cervical vertebra. Which vertebra is it?

During cytoscopy mucous membrane of urinary bladder normally makes folds except for a single triangular area with smooth mucosa. This triangle is located in the following part of urinary bladder:

As a result of an accident a patient has intense painfullness and edema of the anterior crus surface; dorsal flexion of foot is hindered. Function of which crus muscle is most likely to be disturbed?

A 40-year-old patient complains of intensive heartbeats, sweating, nausea, visual impairment, arm tremor, hypertension. From his anamnesis: 2 years ago he was diagnosed with pheochromocytoma. Hyperproduction of what hormones causes the given pathology?

A patient who suffers from cancer of back of tongue has an intense bleeding as a result of affection of dorsal lingual artery by the tumour. What vessel should be ligated to stop bleeding?

A 58-year-old patient with acute cardiac insufficiency has decreased volume of daily urine – oliguria. What is the mechanism of this phenomenon?

An 18-year-old man was delivered to the hospital after a road accident. Examination at the traumatological department revealed multiple injuries of soft tissues of face in the region of the medial eye angle. The injuries caused massive haemorrhage. What arterial anastomosis might have been damaged in this region?

After a 2 y.o. child has had flu, there appeared complaints about ear ache. A doctor revealed hearing impairment and inflammation of the middle ear. How did the infection penetrate into the middle ear?

A 40-year-old woman was admitted to the infectious diseases department with high body temperature. Objectively: marked meningeal symptoms. A spinal cord punction was made. What anatomic formation was puncturated?

A patient’s knee joint doesn’t extend, there is no knee-jerk reflex, skin sensitivity of the anterior femoral surface is disturbed. What nerve structures are damaged?

After resection of the middle third of femoral artery obliterated by a thromb the lower extremity is supplied with blood due to the surgical bypass. Name an artery that plays the main role in reestablishment of blood flow:

A 50 y.o. patient was admitted to the hospital with complaints about pain behind his breastbone, asphyxia during physical activity. Angiography revealed pathological changes in the posterior interventricular branch of the right coronary artery. What heart parts are affected?

A patient was admitted to the surgical department with suspected inflammation of Meckel’s diverticulum. What part of bowels should be examined in order to discover the diverticulum in course of an operation?

Examination of a newborn boy’s genitals revealed a cleft of urethra that opens on the inferior surface of his penis. What developmental anomaly is meant?

A patient complains about impaired evacuatory function of stomach (long-term retention of food in stomach). Examination revealed a tumour of initial part of duodenum. Specify localization of the tumour:

A young man consulted a doctor about disturbed urination. Examination of his external genitals revealed that urethra is split on top and urine runs out of this opening. What anomaly of external genitals development is the case?

As a result of a continuous chronic encephalopathy, a patient has developed spontaneous motions and a disorder of torso muscle tone. These are the symptoms of the disorder of the following conduction tract:

A 35 year old patient applied to a doctor with complaints about having intense rhinitis and loss of sense of smell for a week. Objectively: nasal cavity contains a lot of mucus that covers mucousmembrane and blocks olfactory receptors. In what part of nasal cavity are these receptors situated?

As a result of a craniocerebral injury, a patient has a decreased skin sensitivity. What area of the cerebral cortex is likely to be damaged?

A 40-year-old patient has ulcer perforation in the posterior wall of stomach. What anatomical structure will blood and stomach content leak to?

Inflammatory process of modified subserous layer around cervix of the uterus caused an intensive pain syndrome. In what region of genitals does the pathological process take place?

In course of an operation surgeon removed a part of a lung that was ventilated by a tertiary bronchus accompanied by branches of pulmonary artery and other vessels. What part of a lung was removed?

Angiocardiography of a 60-year-old male patient revealed constriction of a vessel located in the left coronary sulcus of the heart. What is the pathological vessel called?

A patient complains of pain in the right lateral abdomen. Palpation revealed a dense, immobile, tumor-like formation. A tumor is likely to be found in the following part of the digestive tube:

While examining the oral cavity a stomatologist revealed inflammation of papillae on the border of the median and posterior third of the back of tongue. What papillae are inflamed?

Examination of a patient revealed an abscess of pterygopalatine fossa. Where can the infection spread to unless the disease is managed in time?

A patient with cholelithiasis fell ill with mechanic jaundice. Examination revealed that the stone was in the common bile duct. What bile-excreting ducts make up the obturated duct?

Neurological examination of a 65 y.o. patient revealed a haemorrhage within the superior temporal gyrus. In the blood supply area of which artery is it?

A 70 y.o. man has cut an abscess off in the area of mammiform process during shaving. Two days later he was admitted to the hospital with inflammation of arachnoid membranes. How did the infection penetrate into the cavity of skull?

The cerebrospinal fluid is being examined for the purpose of diffrential meningitis diagnostics. At what site is the lumbal puncture safe?

A female patient has facial neuritis that has caused mimetic paralysis and hearing impairment. Hearing impairment results from the paralysis of the following muscle:

Part of alveoles of a preterm infant didn’t spread because of enhanced elastic recoil of lungs. How can this recoil be reduced?

Preventive examination of a patient revealed an enlarged lymph node of metastatic origin on the medial wall of the left axillary crease. Specify the most likely localization of the primary tumour:

A man suffering from osteochondrosis got acute pain in the abdominal muscles (lateral and anterior). During objective examination a physician diagnosticated increased pain sensitivity of skin in the hypogastric region. This pain might be caused by affection of the following nerve:

A woman suffering from osteochondrosis felt acute pain in her humeral articulation that became stronger when she abducted her shoulder. These symptoms might be caused by damage of the following nerve:

Pyeloureterography X-ray photo showed a renal pelvis with minor calyces only (major calyces were absent). What form of urinary tracts of a kidney was revealed?

A patient has a deep cut wound on the posterior surface of his shoulder in its middle third. What muscle might be injured?

A patient has pain, edema and reddening of his skin in the anterosuperior area of his thigh and his foot’s thumb. What lymph nodes of his lower extremity responded to the inflammatory process?

A patient got a craniocerebral trauma that resulted in right-side convergent strabismus. Damage of which craniocerebral nerve caused such consequences?

In case of a penetrating wound of the anterior abdominal wall the wound tract went above the lesser curvature of stomach. What peritoneum formation is most likely to be injured?

After a trauma a patient lost ability of elbow extension. This might have been caused by dysfunction of the following main muscle:

While playing a child got a punch in the presternum region. As a result of this trauma an organ located behind the presternum was damaged. Name this organ:

A patient complains of acute pain attacks in the right lumbar region. During examination the nephrolithic obturation of the right ureter in the region between its abdominal and pelvic segments has been detected. What anatomical boundary exists between those two segments?

After a craniocerebral trauma a patient lost the ability to execute learned purposeful movements (apraxia). The injury is most likely localized in the following region of the cerebral cortex:

A patient got an injury of spinal marrow in a road accident that caused loss of tactile sensation, posture sense, vibration sense. What conduction tracts are damaged?

Examination of a patient revealed hypertrophy and inflammation of lymphoid tissue, edema of mucous membrane between palatine arches (acute tonsillitis). What tonsil is normally situated in this area?

While performing an operation in the area of axillary crease a surgeon has to define an arterial vessel surrounded by fascicles of brachial plexus. What artery is it?

Examination of a patient with impaired blood coagulation revealed thrombosis of a branch of inferior mesenteric artery. What bowel segment is damaged?

A patient was admitted to the surgical department with inguinal hernia. During the operation the surgeon performs plastic surgery on posterior wall of inguinal canal. What structure forms this wall?

In order to prevent massive haemorrhage in the region of oral cavity floor it is required to ligate an artery which is located within Pirogov’s triangle. What artery is it?

A man with an injury of the dorsal area of his neck was admitted to the resuscitation department. What muscle occupies this area?

A patient complains of dizziness and hearing loss. What nerve is damaged?

While palpating mammary gland of a patient a doctor revealed an induration in form of a node in the inferior medial quadrant. Metastases may extend to the following lymph nodes:

A patient got a trauma that caused dysfunction of motor centres regulating activity of head muscles. In what parts of cerebral cortex is the respective centre normally localized?

A patient was diagnosed with paralysis of facial and masticatory muscles. The haematoma is inside the genu of internal capsule. What conduction tract is damaged?

A patient has lost skin sensitivity in the region of the medial surface of his shoulder. This is the result of dysfunction of the following nerve:

A foreign body (a button) closed space of the right superior lobar bronchus. What segments of the right lung won’t be supplied with air?

A patient was diagnosed with bartholinitis (inflammation of greater vulvovaginal glands). In which organ of urogenital system are these glands localized?

While performing an inguinal canal operation on account of hernia a surgeon damaged the canal’s contents. What exactly was damaged?

Ultrasonic examination of a patient revealed aneurism in the area of aortic arch that caused alteration of vocal function of larynx. What nerve was constricted?

Surgical approach to the thyroid gland from the transverse (collar) approach involves opening of interaponeurotic suprasternal space. What anatomic structure localized in this space is dangerous to be damaged?

In course of a small pelvis operation it became necessary to ligate an ovarian artery. What  formation may be accidentally ligated together with it?  

An injured person was delivered to the hospital with a penetrating wound in the left lateral region of abdomen. What part of the large intestine is most likely damaged?

After a road accident a driver was delivered to the hospital with an injury of the medial epicondyle of humerus. What nerve might be damaged in this case?

A patient with a knife wound in the left lumbal part was delivered to the emergency hospital. In  course of operation a surgeon found that internal organs were not damaged but the knife injured one of muscles of renal pelvis. What muscle is it?

A 25 year old patient was examined by a medical board. Examination revealed pathology of chest. Transverse dimensions were to small and the sternum was strongly protruding. What chest type is it?

A man with a stab wound in the area of quadrilateral foramen applied to a doctor. Examination revealed that the patient was unable to draw his arm aside from his body. What nerve is most  probably damaged?

Brain tomography revealed a tumour in the region of red nucleus. What part of brain is damaged?