1
Q
In a supine patient with the arm abducted 80°, what is the direction of the thumb during wrist supination and pronation?
A
Supination → Thumb moves superior (upward)
Pronation → Thumb moves inferior (downward)
2
Q
In a prone patient, how are the dorsal roots of spinal nerves positioned relative to the ventral roots?
A
Dorsal roots are superficial to ventral roots.
3
Q
What two structures are connected in a choledochoduodenostomy?
A
Common bile duct and duodenum
4
Q
Where is the anteromedial portal placed during knee arthroscopy?
A
Proximal and anterior to the pes anserinus, medial to the patellar ligament
5
Q
Where is epidural anesthesia administered?
A
Into the epidural space — between the spinal canal and the dura mater
6
Q
Which connective tissue structure transmits quadriceps muscle contraction from the patella to the tibial tuberosity?
A
Patellar ligament
7
Q
The acetabulum is formed by the fusion of which three bones?
A
Ilium, Ischium, and Pubis
8
Q
The superior mesenteric artery (SMA) primarily supplies which structure?
A
Pancreas (head & uncinate process)
Exam Pearl:
Celiac = Foregut
SMA = Midgut
IMA = Hindgut
9
Q
The uterine artery most commonly branches from which artery?
A
Internal iliac artery
10
Q
What is the primary physiologic effect of placing a patient in Trendelenburg position?
A
Increased cerebral blood flow
11
Q
Following blunt chest trauma with hypotension and respiratory distress, what condition is most likely and requires urgent surgical intervention?
A
Cardiac tamponade
12
Q
What laboratory abnormality may cause acute cyanosis during surgery?
A
Lower than normal hemoglobin
13
Q
During carotid endarterectomy, inadvertent stimulation of the vagus nerve may cause what transient effect?
A
Bradycardia
14
Q
Damage to which nerve at the fibular head causes foot drop?
A
Common peroneal nerve
15
Q
The recurrent laryngeal nerve is a branch of which nerve?
A
Vagus nerve (CN X)
16
Q
The anatomic region bordered by the cystic duct, common hepatic duct, and cystic artery is called what?
A
Calot’s triangle (hepatocystic triangle)
17
Q
The inferior mesenteric artery (IMA) primarily supplies which colon landmark?
A
Splenic flexure
18
Q
The short gastric arteries arise directly from which artery?
A
Splenic artery
19
Q
During adrenal gland manipulation (e.g., pheochromocytoma), what is the greatest intraoperative systemic risk?
A
Rapid blood pressure changes
20
Q
Which peritoneal fold connects the sides of the uterus to the pelvic walls and floor?
A
Broad ligament
21
Q
Primary somatic innervation to the external genitalia is supplied by which nerve?
A
Pudendal nerve (S2–S4)
22
Q
What is the correct pathway of urine flow from the kidney to the bladder?
A
Bowman’s capsule → Collecting ducts → Renal calyx → Renal pelvis → Ureter → Bladder → Urethra
23
Q
How does hypoventilation affect anesthetic emergence?
A
Hypoventilation slows anesthetic elimination and delays recovery.
24
Q
Cranial nerve X is which nerve?
A
Vagus nerve
25
Which anatomical triangle is bounded by:
Posterior belly of digastric (superior)
Medial border of sternocleidomastoid (lateral)
Superior belly of omohyoid (inferior)?
Carotid triangle
26
What major structures are contained within the carotid triangle?
Common carotid artery
Internal carotid artery
External carotid artery
Internal jugular vein
Vagus nerve
Hypoglossal nerve
27
How can you distinguish the external carotid artery (ECA) from the internal carotid artery (ICA) in the neck?
External carotid artery has branches in the neck (superior to bifurcation).
Internal carotid artery has NO branches in the neck.
28
Primary superficial sensation to the cheek and lateral nose comes from which nerve?
Maxillary division (V2) of the trigeminal nerve (CN V).
29
Which structures pass through the thoracic outlet and are affected in thoracic outlet syndrome?
Subclavian artery
Subclavian vein
Brachial plexus
30
The tricuspid valve lies between which two chambers of the heart?
Right atrium and right ventricle
31
The internal mammary (internal thoracic) arteries arise directly from which vessels?
Subclavian arteries
32
Which abdominal incision avoids contact with the posterior rectus sheath?
Pfannenstiel incision
33
Which abdominal incision allows for single-layer fascial closure?
Midline incision
34
Which incision provides anterior access to the spleen while preserving rectus muscle innervation?
Paramedian incision
35
Which abdominal structure is completely intraperitoneal?
Transverse colon
36
The superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) anastomose through which vessel?
Marginal artery (of Drummond)
37
The cystic artery most commonly arises from which vessel?
Right hepatic artery
38
Which liver lobe is located medial and slightly superior to the gallbladder?
Quadrate lobe
39
During pelvic lymph node dissection, injury to which nerves can cause urinary dysfunction?
Pelvic (parasympathetic) nerves
Hypogastric (sympathetic) nerve
Pudendal (somatic) nerve
40
The inferior epigastric artery lies in what relationship to the internal inguinal ring?
Medial to the internal inguinal ring
41
The mnemonic “NAVY” identifies structures in which anatomical region?
Femoral triangle
NAVY (lateral → medial):
N – Nerve
A – Artery
V – Vein
Y – “Your” (lymphatics/femoral canal)
42
What is the largest nerve in the human body?
Sciatic nerve
43
Thickening (hypertrophy) of the ligamentum flavum most commonly causes what condition?
Central spinal stenosis
44
Which structure is innervated by the cervical plexus (ansa cervicalis)?
Omohyoid muscle
45
During carpal tunnel decompression, which nerve is at greatest risk?
Median nerve
46
Forearm compartment syndrome compressing the median and ulnar nerves, as well as the radial and ulnar arteries, requires fasciotomy of which compartments?
Deep and superficial volar compartments
47
Which muscle originates from the supraglenoid tubercle?
Long head of the biceps
48
Which ligament serves as a key landmark in shoulder arthroscopy?
Coracoacromial ligament
49
Which branch of the sciatic nerve supplies the flexor muscles of the distal lower extremity?
Tibial nerve
50
Which artery is at greatest risk during posterior cruciate ligament (PCL) surgery?
Popliteal artery
51
What is the surgical significance of the adductor hiatus?
It marks the transition from femoral artery to popliteal artery and is used as a distal anastomosis landmark in fem–pop bypass.
52
Where is the posterior tibial pulse located?
Posterior to the medial malleolus
53
Which two cranial nerves must be identified and preserved during carotid endarterectomy?
Cranial nerves X (Vagus) and XII (Hypoglossal)
54
During carotid surgery, prevention of emboli entering which vessel is most critical?
Internal carotid artery
55
Why is lidocaine injected into the carotid body before arteriotomy?
To prevent reflex sinus bradycardia.
56
What is the primary purpose of cardioplegic solution during cardiac surgery?
Reversibly arrest the heartbeat.
57
Where is the greater saphenous vein located distally?
Anterior to the medial malleolus
58
What is the correct external → internal order of abdominal wall layers before entering the peritoneum?
Scarpa’s fascia → Obliques → Transversus abdominis → Transversalis fascia → Peritoneum
59
What defines the closed (Veress) technique for establishing pneumoperitoneum?
Veress needle insertion + confirmation of placement (negative aspiration/saline test) + controlled CO₂ insufflation.
60
Cystic duct obstruction causing clear mucoid gallbladder contents is known as:
Hydrops (mucocele) of the gallbladder
61
What is the correct traction to identify the cystic duct safely during cholecystectomy?
Gallbladder fundus retracted superiorly; infundibulum retracted laterally.
62
A ruptured appendix without visible bowel contents is classified as what wound class (AORN)?
Class III – Contaminated
63
During open inguinal hernia repair, which nerves must be identified and preserved?
Ilio-inguinal and ilio-hypogastric nerves
64
Where does a direct inguinal hernia protrude?
Through Hesselbach’s triangle, medial to the inferior epigastric vessels.
65
Suction drains with compression dressings after mastectomy primarily reduce the risk of what complication?
Post-operative seroma
66
What is the purpose of “straight-up” skin retraction during cautery dissection?
To decrease skin perforation and thermal damage from electrocautery.
67
Injury to the long thoracic nerve results in paralysis of which muscle?
Serratus anterior
68
Which procedure carries the highest risk of inadvertent retroperitoneal injury (especially ureter)?
Sigmoid colectomy
69
The right colic artery is a branch of which vessel?
Superior mesenteric artery (SMA)
70
The three longitudinal muscle bands along the colon are called:
Taenia coli
71
What is the primary difference between Connell and Cushing sutures?
Connell penetrates the mucosa (enters the lumen).
Cushing does not penetrate the mucosa.
72
During laminotomy, which ligament is encountered just anterior to the lamina?
Ligamentum flavum
73
Which meningeal layers protect spinal nerve roots and ganglia?
Dura mater and arachnoid mater
74
According to AO standards, rigid fixation across an open growth plate is generally:
Contraindicated in pediatric surgery
75
Which structure inserts into the tibial tubercle?
Patellar ligament
76
During tibial trial in TKA, release of which ligament insertion may be needed for varus deformity?
Medial distal insertion (MCL at tibia).
77
What does “eversion” of skin edges mean during closure?
Turning the skin edges upward to align dermal margins.
78
Which two electrolytes are essential for normal cardiac contractions?
Potassium and Calcium.
79
The thyroid gland consists of which anatomical structures?
Right and left lobes joined by the isthmus.
80
Which large artery arises from the left side of the aortic arch and descends into the arm?
The subclavian artery.
81
The arterial supply to most of the intestinal tract (except stomach, duodenum, distal rectum) is derived from which arteries?
Superior and inferior mesenteric arteries.
82
What tissue composes the inner lining of the GI tract mucosa?
Epithelium.
83
What is the normal pH range of blood?
7.3–7.4.
84
What veins drain the intracranial venous sinuses to veins outside the skull?
Emissary veins.
85
Which arteries supply blood to the brain?
Vertebral arteries and internal carotid arteries.
86
Which artery divides into the anterior and middle cerebral arteries?
Internal carotid artery.
87
What is a direct branch of the internal carotid artery?
Middle cerebral artery.
88
The lateral ventricles communicate with the third ventricle through what structure?
Foramen of Monro.
89
The third ventricle empties into the fourth ventricle through what structure?
Aqueduct of Sylvius.
90
Cerebrospinal fluid (CSF) is produced by what structure?
Choroid plexus.
91
What fold of dura mater separates the cerebral hemispheres?
Falx cerebri.
92
What separates the frontal and temporal lobes?
Fissure of Sylvius (lateral sulcus).
93
The frontal lobe is bounded posteriorly by which structure?
Central sulcus (Fissure of Rolando).
94
Which area located in the frontal gyrus controls speech production?
Broca’s area.
95
The white line of Hilton is located between which two structures?
External and internal anal sphincters.
96
In which skin layer is adipose tissue primarily located?
Subcutaneous layer.
97
Collagen is produced by which connective tissue cells?
Fibroblasts.
98
What is normal cardiac output for an adult?
5–6 liters per minute.
99
Which vein drains the right side of the vertebral column?
Azygos vein.
100
Which artery supplies the cecum, ascending colon, hepatic flexure, and proximal transverse colon?
Superior mesenteric artery.
101
The celiac trunk trifurcates into which three arteries?
Left gastric, splenic, and common hepatic arteries.
102
What is the prolongation of breast tissue in the upper outer quadrant extending into the axilla called?
Axillary tail of Spence.
103
What fibrous structures anchor the breast to the overlying skin and underlying pectoral fascia?
Suspensory ligaments of Cooper.
104
What arteries supply blood to the breast?
Branches of the internal mammary, axillary, and lateral thoracic arteries.
105
What is the loose areolar tissue separating the breast from the pectoralis major muscle?
Retromammary space.
106
Which lymph nodes are located between the pectoralis major and minor muscles?
otter’s nodes (interpectoral nodes).
107
Which nerve travels along the anterior-lateral chest wall and innervates the serratus anterior muscle?
Long thoracic nerve.
108
Which nerve innervates the latissimus dorsi muscle?
Thoracodorsal nerve.
109
The nerve of Grassi is associated with which organ?
Stomach.
110
The veins of Sappey drain which structure?
Diaphragm.
111
The node of Lund is located in which anatomical region?
Triangle of Calot.
112
Where is Hartmann’s pouch located?
Gallbladder infundibulum.
113
What are the small ducts that drain bile directly into the gallbladder called?
Hepatic ducts (accessory ducts of Luschka).
114
What is the name of the small pancreatic duct?
Duct of Santorini.
115
What three structures form the anatomical triangle of Calot?
Cystic duct, common hepatic duct, and lower edge of the liver.
116
What is the point where the posterior rectus sheath ends inferiorly called?
Arcuate line.
117
At what point does the external iliac artery become the femoral artery?
At the inguinal ligament.
118
What is the avascular area in the mesentery to the left of the middle colic artery called?
Space of Riolan.
119
What is the series of arterial arcades along the mesenteric border of the colon called?
Marginal artery of Drummond.
120
What are the valves of the gallbladder called?
Valves of Heister.
121
Which nerve lies lateral to the long thoracic nerve and innervates the latissimus dorsi muscle?
Thoracodorsal nerve.
122
Which ligament connects the thyroid gland to the trachea?
Berry ligament (Suspensory ligament of the thyroid).
123
What structure binds the small intestine to the posterior abdominal wall?
Mesentery.
124
Which arteries supply the stomach?
Left gastric, right gastric, right gastroepiploic, left gastroepiploic, and short gastric arteries.
125
Which two muscles form the pelvic diaphragm?
Levator ani and coccygeus.
126
Jackson’s membrane is found near which structure?
Cecum.
127
What is the flexure between the transverse colon and the descending colon called?
Splenic flexure.
128
What is the anastomosis between the superior and inferior mesenteric arteries called?
Long anastomosis of Riolan.
129
Which nerve innervates the diaphragm?
Phrenic nerve.
130
What fibrous structure forms from the fusion of the rectus sheaths from xiphoid to pubic symphysis?
Linea alba.
131
The liver is divided into two principal lobes by which ligament?
Falciform ligament.
132
What sphincter is located at the distal end of the common bile duct entering the duodenum?
Sphincter of Oddi.
CSFA Challenge
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