NEET-PG 2024 Practice Questions

Q: Identify the arrow marked nerve ![img-2.jpeg](img-2.jpeg)

Medial pectoral nerve. ***Medial pectoral nerve*** - The arrow points to a nerve that is seen perforating the **pectoralis minor muscle**. This is a key anatomical landmark for the **medial pectoral nerve**. - This nerve supplies both the **pectoralis major** and **pectoralis minor** muscles, originating from the medial cord of the brachial plexus. *Long thoracic nerve* - The **long thoracic nerve** typically runs superficial to the serratus anterior muscle, not perforating the pectoralis minor. - Injury to this nerve results in **winged scapula** due to paralysis of the serratus anterior, which is distinct from the function of the nerve shown. *Thoracodorsal nerve* - The **thoracodorsal nerve** primarily innervates the **latissimus dorsi muscle** and typically runs along the lateral border of the scapula and axilla, not in the anterior chest wall where the pectoralis minor is located. - It arises from the **posterior cord of the brachial plexus**. *Lateral pectoral nerve* - The **lateral pectoral nerve** arises from the lateral cord and typically supplies only the **pectoralis major muscle**. - It often passes **medial to the pectoralis minor muscle** or penetrates the muscle from a more lateral aspect, but does not perforate it in the characteristic way shown for the medial pectoral nerve. *Suprascapular nerve* - The **suprascapular nerve** arises from the **upper trunk of the brachial plexus** and passes through the **suprascapular notch** beneath the superior transverse scapular ligament. - It innervates the **supraspinatus** and **infraspinatus** muscles and is located in the posterior shoulder region, not in the anterior chest wall where the structure shown is located.

Q: The nerve passing through the arrow-marked region in the provided image has been lesioned. Which of the following is the most likely clinical presentation?

Loss of sensation in the maxillary area of the face. ***Loss of sensation in the maxillary area of the face*** - The arrow points to the **foramen rotundum**, which transmits the **maxillary nerve (V2)**, a branch of the trigeminal nerve. - Lesion of the maxillary nerve (V2) leads to sensory loss in the **maxillary region of the face**, including the cheek, upper lip, upper teeth, and palate. *Loss of sensation in the jaw area* - Sensation in the jaw area, including the lower teeth and chin, is primarily supplied by the **mandibular nerve (V3)**, which exits through the foramen ovale. - A lesion at the foramen rotundum would not directly affect V3. *Loss of sensation on the scalp and nose* - Sensation to the scalp (anterior part) and nose is primarily supplied by the **ophthalmic nerve (V1)**, which exits the skull through the superior orbital fissure. - The foramen rotundum is not involved in the passage of the ophthalmic nerve. *Loss of sensation in the mucosa of nasopharynx* - While parts of the nasopharynx mucosa receive innervation from V2, this is a very specific and limited area, and the primary and most prominent sensory loss from a V2 lesion would be in the **maxillary facial region**. - Other nerves like the glossopharyngeal nerve also contribute to nasopharyngeal sensation. *Loss of motor function to muscles of facial expression* - Motor function to muscles of facial expression is supplied by the **facial nerve (CN VII)**, not the maxillary nerve (V2). - The maxillary nerve is a purely **sensory** branch of the trigeminal nerve and has no motor function. - The facial nerve exits the skull through the stylomastoid foramen, not the foramen rotundum.

Q: The covering of an omphalocele is derived from which of the following layers?

Amnion. ***Amnion*** - An **omphalocele** is a congenital abdominal wall defect where abdominal contents protrude through the umbilical ring, covered by a sac derived from the **amnion** and peritoneum. - The covering of an omphalocele defect is an intact peritoneal sac that is covered externally by **amnion**. *Chorion* - The **chorion** is the outermost membrane surrounding an embryo, providing protection and nourishment, but it does not form the covering of an omphalocele. - It works in conjunction with the decidua to form the **placenta** and has finger-like projections called villi on its outer surface. *Mesoderm* - The **mesoderm** is one of the three primary germ layers in embryonic development, giving rise to connective tissue, muscle, and blood cells. - **Fetal skin**, not the omphalocele covering, develops from the mesoderm and ectoderm. *Endoderm* - The **endoderm** is the innermost of the three primary germ layers, giving rise to the lining of the digestive tract and respiratory system. - The omphalocele covering is derived from the amnion, not the endoderm, which is involved in forming internal organs. *Ectoderm* - The **ectoderm** is the outermost of the three primary germ layers, giving rise to the nervous system, skin epidermis, and sensory organs. - While ectoderm contributes to skin development, the omphalocele sac is specifically covered by amnion, not ectodermal derivatives.

Q: A singer presents with difficulty singing at a high pitch. On examination, bowing of the vocal cord is observed on the right side. Which of the following muscles has likely been compromised?

Cricothyroid. ***Cricothyroid*** - The **cricothyroid muscle** is primarily responsible for **tensioning and elongating the vocal cords**, which is crucial for increasing vocal pitch. - Damage to this muscle or its innervation (superior laryngeal nerve) results in an inability to reach higher pitches and can cause **vocal cord bowing** due to reduced tension. *Posterior cricoarytenoid* - This muscle is the **primary abductor** of the vocal cords, meaning it opens the vocal cords for breathing. - Compromise would lead to difficulty breathing or a paralyzed vocal cord in the adducted position, not bowing with difficulty singing high notes. *Lateral cricoarytenoid* - The **lateral cricoarytenoid muscle** is a **vocal cord adductor** and rotator, bringing the vocal cords together to regulate voice intensity. - Dysfunction typically results in a weak and breathy voice, or difficulty bringing the cords together, not specifically difficulty with high pitch. *Thyroarytenoid* - The **thyroarytenoid muscle** (which includes the vocalis muscle) acts to **relax and shorten the vocal cords**, lowering pitch and modulating vocal cord tension. - Dysfunction would primarily lead to difficulty with lower pitches or a hoarse voice, as it prevents proper relaxation of the vocal cords.

Q: What is the diagnosis based on the image shown ![img-5.jpeg](img-5.jpeg)

Bladder exstrophy. ***Bladder exstrophy*** - The image distinctly shows an **exposed urinary bladder** on the abdominal wall, a hallmark of bladder exstrophy. - This congenital anomaly results from a **failure of midline closure** of the infraumbilical abdominal wall and bladder. *Omphalocele* - An omphalocele involves protrusion of **abdominal viscera** (intestines, liver) into the base of the umbilical cord. - The herniated organs are typically **covered by a sac** composed of peritoneum and amnion, which is absent in the image. *Umbilical hernia* - An umbilical hernia is a protrusion of abdominal contents through the **umbilical ring**, but the skin remains intact and covers the defect. - The image clearly shows an **exposed organ** without skin coverage, ruling out an umbilical hernia. *Gastroschisis* - Gastroschisis involves the **evisceration of intestines** through a full-thickness abdominal wall defect, usually to the right of the umbilical cord. - Unlike the image, the defect in gastroschisis is typically **much smaller** and primarily involves the bowel, not the bladder, and there is no covering sac. *Epispadias* - Epispadias is a **urethral defect** where the urethral opening is on the dorsal (upper) surface of the penis or anterior bladder neck. - While epispadias is part of the **exstrophy-epispadias complex** and often associated with bladder exstrophy, it does not present with an **exposed bladder** on the abdominal wall as seen in the image.

Q: Match the following receptors with their correct functions: Receptors: 1. Ruffini corpuscle 2. Merkel cells 3. Pacinian corpuscle 4. Meissner's corpuscle Functions: A. Vibration B. Sustained pressure C. Stretching D. Fine touch Select the option that correctly matches each receptor (1-4) with its function (A-D).

1C 2B 3A 4D. ***1C 2B 3A 4D*** - **Ruffini corpuscles** (1) detect **stretching** (C) of the skin. They are **slow-adapting Type II mechanoreceptors** located deep in the dermis, responding to sustained skin stretch and contributing to proprioception. - **Merkel cells** (2) detect **sustained pressure** (B) and fine texture discrimination. They are **slow-adapting Type I mechanoreceptors** with the highest spatial resolution, providing detailed information about touch. - **Pacinian corpuscles** (3) detect **vibration** (A), particularly high-frequency vibrations (200-300 Hz). They are **rapidly adapting receptors** with an onion-like lamellated structure located deep in the dermis and subcutaneous tissue. - **Meissner's corpuscles** (4) detect **fine touch** (D) and light pressure. They are **rapidly adapting receptors** located in dermal papillae of glabrous (hairless) skin, particularly abundant in fingertips and lips. *1C 2D 3B 4A* - Incorrectly assigns Merkel cells to fine touch (should be sustained pressure) and Pacinian corpuscles to sustained pressure (should be vibration). - Meissner's corpuscles are mismatched with vibration instead of fine touch. *1D 2C 3B 4A* - Incorrectly assigns Ruffini corpuscles to fine touch (should be stretching) and Merkel cells to stretching (should be sustained pressure). - Pacinian corpuscles are mismatched with sustained pressure (should be vibration). - Meissner's corpuscles are mismatched with vibration (should be fine touch). *1B 2A 3D 4C* - Completely incorrect matching: Ruffini to sustained pressure, Merkel to vibration, Pacinian to fine touch, and Meissner's to stretching. - Demonstrates fundamental misunderstanding of mechanoreceptor functions.

Q: A patient presents with fecal discharge from the umbilicus. What is the most likely diagnosis?

Patent vitelline duct. ***Patent vitelline duct*** - **Fecal discharge from the umbilicus** indicates a persistent communication between the **ileum** and the **umbilicus** through a patent vitelline (omphalomesenteric) duct. - This congenital anomaly represents a remnant of the **omphalomesenteric duct** that **completely failed to involute**, creating a **fistulous tract** allowing intestinal contents to exit through the umbilicus. - This is the **most complete form** of vitelline duct persistence (other forms include Meckel's diverticulum, fibrous band, or umbilical polyp). *Urachal fistula* - A urachal fistula occurs when the **urachus** remains patent, creating a connection between the **bladder** and the umbilicus. - While it can result in umbilical discharge, the discharge would be **urine**, not feces. *Omphalocele* - An omphalocele is a **congenital abdominal wall defect** where abdominal contents protrude into a sac at the base of the umbilicus. - It does not involve a fistulous communication with intestines causing fecal discharge, but rather a **herniation** of organs covered by a peritoneal membrane. *Gastroschisis* - Gastroschisis is a congenital anomaly characterized by the **protrusion of abdominal organs** directly into the amniotic cavity **without a covering sac**, usually to the **right of the umbilicus**. - Like omphalocele, it's a **herniation defect** presenting at birth and does not involve an abnormal fistulous connection causing fecal discharge from the umbilicus.

Q: What is the diagnosis based on the image shown?

Umbilical fistula. ***Umbilical fistula*** - The image shows a **patent vitelline duct (omphalomesenteric duct)**, which creates a direct connection between the umbilicus and the ileum, visible as an umbilical fistula. - This condition presents with **fecal discharge from the umbilicus** or **umbilical prolapse of intestinal mucosa**. *Ileal diverticulum* - An ileal diverticulum, such as a **Meckel's diverticulum**, is a blind pouch protruding from the ileum, usually not communicating with the umbilicus. - It would typically be noted as an **outpouching of the ileal wall**, without an external opening at the umbilicus unless complicated by rupture. *Urachal cyst* - A urachal cyst is a remnant of the **urachus**, which connects the bladder to the umbilicus during fetal development. - It would be located **between the umbilicus and the bladder** and contain urine or serous fluid, not intestinal contents. *Omphalocele* - An omphalocele is a **congenital abdominal wall defect** where abdominal organs protrude into the base of the umbilical cord. - The defect is **covered by a membrane**, and it involves herniation of abdominal contents, not a fistula with the intestine.

Question 1

An absent gag reflex can result from injury to which of the following nerves?

Accepted Answer

Cranial Nerve IX (Glossopharyngeal) and Cranial Nerve X (Vagus)

Answer

Cranial Nerve VII (Facial) and Cranial Nerve V (Trigeminal)

Answer

Cranial Nerve V (Trigeminal) and Cranial Nerve IX (Glossopharyngeal)

Answer

Cranial Nerve X (Vagus) and Cranial Nerve VII (Facial)

Answer

Cranial Nerve XII (Hypoglossal) and Cranial Nerve X (Vagus)

Question 2

Identify the arrow marked nerve
![img-2.jpeg](img-2.jpeg)

Accepted Answer

Medial pectoral nerve

Answer

Long thoracic nerve

Answer

Thoracodorsal nerve

Answer

Lateral pectoral nerve

Answer

Suprascapular nerve

Question 3

Identify the labeling correctly
![img-3.jpeg](img-3.jpeg)

Accepted Answer

A - Ascending aorta, B - Pulmonary trunk, C - Superior vena cava, D - Descending aorta

Answer

A - Ascending aorta, B - Superior vena cava, C - Pulmonary trunk, D - Descending aorta

Answer

A - Superior vena cava, B - Pulmonary trunk, C - Ascending aorta, D - Descending aorta

Answer

A - Pulmonary trunk, B - Ascending aorta, C - Superior vena cava, D - Descending aorta

Answer

A - Ascending aorta, B - Pulmonary trunk, C - Descending aorta, D - Superior vena cava

Question 4

The nerve passing through the arrow-marked region in the provided image has been lesioned. Which of the following is the most likely clinical presentation?

Accepted Answer

Loss of sensation in the maxillary area of the face

Answer

Loss of sensation in the jaw area

Answer

Loss of sensation on the scalp and nose

Answer

Loss of sensation in the mucosa of nasopharynx

Answer

Loss of motor function to muscles of facial expression

Question 5

The covering of an omphalocele is derived from which of the following layers?

Accepted Answer

Amnion

Answer

Chorion

Answer

Mesoderm

Answer

Endoderm

Answer

Ectoderm

Question 6

A singer presents with difficulty singing at a high pitch. On examination, bowing of the vocal cord is observed on the right side. Which of the following muscles has likely been compromised?

Accepted Answer

Cricothyroid

Answer

Posterior cricoarytenoid

Answer

Lateral cricoarytenoid

Answer

Thyroarytenoid

Question 7

What is the diagnosis based on the image shown
![img-5.jpeg](img-5.jpeg)

Accepted Answer

Bladder exstrophy

Answer

Omphalocele

Answer

Umbilical hernia

Answer

Gastroschisis

Answer

Epispadias

Question 8

Match the following receptors with their correct functions:

Receptors:
1. Ruffini corpuscle
2. Merkel cells
3. Pacinian corpuscle
4. Meissner's corpuscle

Functions:
A. Vibration
B. Sustained pressure
C. Stretching
D. Fine touch

Select the option that correctly matches each receptor (1-4) with its function (A-D).

Accepted Answer

1C 2B 3A 4D

Answer

1C 2D 3B 4A

Answer

1D 2C 3B 4A

Answer

1B 2A 3D 4C

Question 9

A patient presents with fecal discharge from the umbilicus. What is the most likely diagnosis?

Accepted Answer

Patent vitelline duct

Answer

Urachal fistula

Answer

Omphalocele

Answer

Gastroschisis

Question 10

What is the diagnosis based on the image shown?

Accepted Answer

Umbilical fistula

Answer

Ileal diverticulum

Answer

Urachal cyst

Answer

Omphalocele

NEET-PG 2024

Anatomy

ENT

Pediatrics

Physiology

Surgery