Vasculature PDF

**1. A 70-year-old woman presents with a severe, throbbing headache localized over her temples. She reports pain when chewing and tenderness when combing her hair. Laboratory tests reveal elevated erythrocyte sedimentation rate (ESR) and C-reactive protein levels. She is also experiencing stiffness...

**1. A 70-year-old woman presents with a severe, throbbing headache localized over her temples. She reports pain when chewing and tenderness when combing her hair. Laboratory tests reveal elevated erythrocyte sedimentation rate (ESR) and C-reactive protein levels. She is also experiencing stiffness in her shoulders and hips. Which of the following conditions is most commonly associated with her primary diagnosis?** A. Polymyalgia rheumatica B. Rheumatoid arthritis C. Systemic lupus erythematosus D. Osteoarthritis **Answer: A** Polymyalgia rheumatica is commonly associated with temporal arteritis (giant cell arteritis), presenting with pain and stiffness in proximal joints like the shoulders and hips. --- **2. A 25-year-old man is struck on the side of the head with a baseball bat and loses consciousness briefly. He regains consciousness but deteriorates rapidly en route to the hospital. Imaging reveals an epidural hematoma. Which artery is most likely injured in this patient?** A. Middle meningeal artery B. Anterior cerebral artery C. Superficial temporal artery D. Facial artery **Answer: A** The middle meningeal artery passes beneath the pterion and is vulnerable to injury leading to an epidural hematoma. --- **3. A patient undergoes surgical removal of a tumor in the carotid triangle. Postoperatively, she exhibits scalp necrosis due to compromised blood supply. Which artery, a branch of the internal carotid artery, is most likely involved?** A. Superficial temporal artery B. Occipital artery C. Supraorbital artery D. Posterior auricular artery **Answer: C** The supraorbital artery, a branch of the ophthalmic artery from the internal carotid artery, supplies the scalp and may be compromised. --- **4. A 40-year-old woman develops a bacterial infection on her upper lip. Shortly after, she presents with symptoms of cavernous sinus thrombosis. Which venous connection facilitated the spread of the infection to the cavernous sinus?** A. Superior ophthalmic vein B. External jugular vein C. Retromandibular vein D. Inferior petrosal sinus **Answer: A** The superior ophthalmic vein connects the facial vein to the cavernous sinus, allowing the spread of infection. --- **5. During a parotid gland surgery, a surgeon must be cautious to preserve the artery that runs horizontally across the face, inferior to the zygomatic arch. Which artery is this?** A. Facial artery B. Transverse facial artery C. Maxillary artery D. Angular artery **Answer: B** The transverse facial artery, a branch of the superficial temporal artery, runs across the face below the zygomatic arch. --- **6. A 7-year-old child frequently suffers from sore throats and enlarged lymph nodes. Examination reveals a persistently enlarged lymph node just below the angle of the mandible. Which lymph node is most likely enlarged?** A. Submental lymph node B. Jugulodigastric lymph node C. Pre-auricular lymph node D. Supraclavicular lymph node **Answer: B** The jugulodigastric lymph node is associated with the tonsils and often remains enlarged in children with frequent tonsillitis. --- **7. A dentist administers a local anesthetic near the mandibular foramen for a dental procedure. Which artery must the dentist be cautious of to avoid inadvertent injection into the vessel?** A. Inferior alveolar artery B. Lingual artery C. Facial artery D. Superior labial artery **Answer: A** The inferior alveolar artery supplies the teeth and runs near the mandibular foramen where nerve blocks are administered. --- **8. A 65-year-old man presents with a painless, hard enlargement of his left supraclavicular lymph node (Virchow's node). This finding is highly suggestive of metastasis from which primary site?** A. Prostate gland B. Stomach C. Lung D. Colon **Answer: B** Enlargement of Virchow's node often indicates gastric (stomach) carcinoma metastasis. --- **9. A patient experiences severe nosebleeds originating from the posterior nasal cavity. Which artery is most likely the source of the bleeding?** A. Anterior ethmoidal artery B. Sphenopalatine artery C. Superior labial artery D. Greater palatine artery **Answer: B** The sphenopalatine artery, a terminal branch of the maxillary artery, supplies the posterior nasal cavity and is a common source of posterior epistaxis. --- **10. A 72-year-old woman complains of sudden vision loss in her right eye. She has a history of temporal headaches and jaw claudication. Which of the following is the most likely cause of her visual symptoms?** A. Optic nerve ischemia due to temporal arteritis B. Retinal detachment C. Central retinal artery occlusion D. Glaucoma **Answer: A** Temporal arteritis can cause optic nerve ischemia leading to sudden, permanent vision loss. --- **11. During reconstructive surgery of the medial canthus of the eye, care must be taken to preserve which artery that supplies this region?** A. Angular artery B. Dorsal nasal artery C. Lacrimal artery D. Supraorbital artery **Answer: A** The angular artery, a branch of the facial artery, supplies the medial corner of the eye. --- **12. A patient suffers a laceration to the temporal region of the scalp. Which artery is most likely to be injured, causing significant bleeding?** A. Superficial temporal artery B. Occipital artery C. Posterior auricular artery D. Middle meningeal artery **Answer: A** The superficial temporal artery supplies the temporal region and lies superficially, making it susceptible to injury. --- **13. A dental abscess in the maxillary molar region has spread to the maxillary sinus. Which arterial branch is most likely involved in spreading the infection?** A. Inferior alveolar artery B. Greater palatine artery C. Posterior superior alveolar artery D. Sphenopalatine artery **Answer: C** The posterior superior alveolar artery supplies the maxillary molars and adjacent structures, facilitating the spread of infection. --- **14. Infections of the face can spread intracranially due to the absence of valves in which of the following structures?** A. Lymphatic vessels B. Facial and cranial veins C. Arterial branches D. Dural sinuses **Answer: B** The absence of valves in facial and cranial veins allows bidirectional blood flow, increasing the risk of intracranial infection spread. --- **15. A patient is suspected of having temporal arteritis. Which diagnostic procedure is considered the gold standard for confirming the diagnosis?** A. Temporal artery biopsy B. MRI of the temporal region C. Doppler ultrasound of the temporal artery D. ESR and CRP blood tests **Answer: A** A temporal artery biopsy is the gold standard for diagnosing temporal arteritis. --- **16. A surgeon performing an ethmoidectomy must be cautious not to damage the arteries supplying the ethmoid sinuses. These arteries are branches of which major artery?** A. Maxillary artery B. Ophthalmic artery C. Facial artery D. Superficial temporal artery **Answer: B** The anterior and posterior ethmoidal arteries branch from the ophthalmic artery. --- **17. During a rhinoplasty, the surgeon must preserve the blood supply to the dorsum of the nose. Which artery, a continuation of the facial artery, supplies this area?** A. Infraorbital artery B. Angular artery C. Dorsal nasal artery D. Supraorbital artery **Answer: B** The angular artery continues from the facial artery to supply the dorsum of the nose. --- **18. A patient has an infection in the middle portion of the face, including the upper lip and cheeks. Into which lymph nodes will this area primarily drain?** A. Submental lymph nodes B. Submandibular lymph nodes C. Pre-auricular lymph nodes D. Deep cervical lymph nodes **Answer: B** Submandibular lymph nodes drain the middle portion of the face. --- **19. A teenager presents with an inflamed and swollen chin due to acne. Which lymph nodes are first to receive lymph drainage from this region?** A. Submandibular lymph nodes B. Submental lymph nodes C. Jugulodigastric lymph nodes D. Supraclavicular lymph nodes **Answer: B** The submental lymph nodes drain the chin area. --- **20. An injury to the infraorbital foramen can affect the structures passing through it. Which artery, a branch of the maxillary artery, exits through this foramen?** A. Infra-orbital artery B. Supraorbital artery C. Superior labial artery D. Angular artery **Answer: A** The infra-orbital artery, a branch of the maxillary artery, exits through the infraorbital foramen. --- **21. A patient with a facial infection develops symptoms of cavernous sinus thrombosis. Which vein provides a direct route for the spread of infection from the face to the cavernous sinus?** A. Retromandibular vein B. Superior ophthalmic vein C. External jugular vein D. Inferior petrosal sinus **Answer: B** The superior ophthalmic vein connects facial veins to the cavernous sinus. --- **22. A lacrimal gland biopsy requires knowledge of its arterial supply. Which artery, branching from the ophthalmic artery, supplies the lacrimal gland?** A. Lacrimal artery B. Supraorbital artery C. Anterior ethmoidal artery D. Dorsal nasal artery **Answer: A** The lacrimal artery supplies the lacrimal gland and is a branch of the ophthalmic artery. --- **23. During a neck surgery, a vein running superficially over the sternocleidomastoid muscle is lacerated. Which vein is this most likely to be?** A. External jugular vein B. Internal jugular vein C. Anterior jugular vein D. Retromandibular vein **Answer: A** The external jugular vein runs superficially along the sternocleidomastoid muscle. --- **24. A patient has swollen lymph nodes just in front of the ear due to an eye infection. Which lymph nodes are these?** A. Submandibular lymph nodes B. Pre-auricular (parotid) lymph nodes C. Submental lymph nodes D. Deep cervical lymph nodes **Answer: B** Pre-auricular (parotid) lymph nodes drain the eyes, nose, and lateral cheek. --- **25. An infection in the scalp spreads to intracranial structures. Which venous structures connect the scalp veins to the dural venous sinuses, facilitating this spread?** A. Emissary veins B. Diploic veins C. Cerebral veins D. Bridging veins **Answer: A** Emissary veins connect extracranial veins to the dural venous sinuses. --- **26. A fracture of the zygomatic bone may damage the artery supplying it. Which artery, branching from the lacrimal artery, supplies the zygomaticofacial region?** A. Zygomaticofacial artery B. Infra-orbital artery C. Angular artery D. Transverse facial artery **Answer: A** The zygomaticofacial artery, from the lacrimal branch of the ophthalmic artery, supplies this area. --- **27. A 68-year-old man presents with left supraclavicular lymphadenopathy and weight loss. Biopsy reveals metastatic cancer cells. Which primary cancer is most likely responsible?** A. Pancreatic carcinoma B. Gastric carcinoma C. Lung carcinoma D. Colorectal carcinoma **Answer: B** Left supraclavicular node (Virchow's node) enlargement often indicates gastric carcinoma metastasis. --- **28. In the mnemonic "Some Attendings Like Freaking Out Potential Medical Students," what does the "F" stand for regarding branches of the external carotid artery?** A. Facial artery B. Frontal artery C. Femoral artery D. First cervical artery **Answer: A** "F" stands for Facial artery in the mnemonic. --- **29. During neurosurgery, a surgeon identifies a foramen transmitting an artery vulnerable in epidural hematomas. Which foramen is this?** A. Foramen spinosum B. Foramen ovale C. Foramen rotundum D. Jugular foramen **Answer: A** The middle meningeal artery passes through the foramen spinosum. --- **30. Long-term high-dose corticosteroid therapy in a patient with temporal arteritis increases the risk of which of the following complications?** A. Hyperthyroidism B. Osteoporosis C. Renal failure D. Anemia **Answer: B** High-dose corticosteroids can lead to osteoporosis. --- **31. A severe nosebleed requires ligation of the main arterial supply to the nasal cavity. Which artery should be targeted?** A. Sphenopalatine artery B. Greater palatine artery C. Superior labial artery D. Anterior ethmoidal artery **Answer: A** The sphenopalatine artery supplies the nasal cavity and is often ligated to control severe epistaxis. --- **32. A laceration above the eyebrow results in profuse bleeding. Which artery is likely injured?** A. Superficial temporal artery B. Supraorbital artery C. Posterior auricular artery D. Occipital artery **Answer: B** The supraorbital artery, a branch of the ophthalmic artery, supplies the area above the eyebrow. --- **33. An anesthetic is injected near the foramen ovale to block sensory input during mandibular surgery. Which nerve passes through this foramen?** A. Maxillary nerve (V2) B. Mandibular nerve (V3) C. Ophthalmic nerve (V1) D. Facial nerve (VII) **Answer: B** The mandibular division of the trigeminal nerve (V3) passes through the foramen ovale. --- **34. A patient with a cavernous sinus thrombosis develops lateral gaze palsy. Which cranial nerve is most likely affected first due to its location within the sinus?** A. Abducens nerve (CN VI) B. Oculomotor nerve (CN III) C. Trochlear nerve (CN IV) D. Optic nerve (CN II) **Answer: A** The abducens nerve (CN VI) lies within the cavernous sinus and is often affected first. --- **35. A surgeon performing a facelift must be careful to avoid damaging the artery that crosses the inferior border of the mandible anterior to the masseter muscle. Which artery is this?** A. Facial artery B. Lingual artery C. Superior labial artery D. Maxillary artery **Answer: A** The facial artery crosses the inferior border of the mandible near the masseter muscle. --- **36. Which vein is primarily responsible for draining venous blood from the brain via the dural venous sinuses?** A. Internal jugular vein B. External jugular vein C. Vertebral vein D. Anterior jugular vein **Answer: A** The internal jugular vein drains blood from the brain via the dural venous sinuses. --- **37. A patient with hyperthyroidism undergoes surgery. Which artery supplying the thyroid gland must be carefully preserved to maintain blood flow to the larynx?** A. Superior thyroid artery B. Inferior thyroid artery C. Thyroid ima artery D. Ascending pharyngeal artery **Answer: A** The superior thyroid artery supplies both the thyroid gland and the larynx. --- **38. A pituitary tumor compresses an optic chiasm. Which cranial nerve is directly affected, leading to visual disturbances?** A. Oculomotor nerve (CN III) B. Optic nerve (CN II) C. Trochlear nerve (CN IV) D. Abducens nerve (CN VI) **Answer: B** Compression of the optic nerve (CN II) can affect vision. --- **39. A central venous catheter is being placed into the subclavian vein. To avoid arterial injury, the clinician must be cautious of which nearby artery?** A. Internal carotid artery B. Subclavian artery C. Vertebral artery D. Axillary artery **Answer: B** The subclavian artery runs close to the subclavian vein and must be avoided during catheter placement. --- **40. Sudden occlusion of which artery would most likely result in loss of vision due to its supply to the retina?** A. Central retinal artery B. Lacrimal artery C. Posterior ciliary artery D. Supraorbital artery **Answer: A** The central retinal artery, a branch of the ophthalmic artery, supplies the retina. ---