This document contains an anatomy exam for second year medical students in Egypt with 6 questions covering various body systems. Question 1 focuses on head anatomy and includes parts asking students to draw diagrams of venous drainage of the scalp, describe differences in scalp wounds, origin/insertion/nerve supply/action of the medial pterygoid muscle, and enumerate nerves supplying the dura mater. It also includes a short clinical case about an abscess on the nose.

1. Tanta University second Year Final Anatomy Exam. (Egyptians)
Faculty of Medicine Number of Questions:6
Anatomy Department Time Allowed: 3 Hours
4/6/2014 Total: 125 Marks
Very Important:each partof question mustbe written in a separate page

 QUESTION (1) (Head)…………………………………….(22 MARKS):
A- Draw a diagram showing venous drainage of the scalp and face. Mention the differences between
cut wounds in connective tissue layer of scalp and aponeurosis of occipitofrontalis …………..(5 marks)
B- Mention origin, insertion, nerve supply and action of medial pterygoid muscle (diagram not
needed)……………………………………………………………………………………………………….......(5 marks)
C- Enumerate nerves supplying the dura mater (diagram not needed)………………………………(4 marks)
D- Enumerate the branches of ophthalmic artery (diagram needed)………………………………….(5 marks)
E- Problem solving (3 marks):
A 15 years-old girl visited her physician complaining of an abscess on the right side of her nose and
severe pain in her nose. The physician gave her antibiotics and asked her not to squeeze the abscess
because it is in the dangerous area of the face.
1- What is the dangerous area of the face………………….…………………………………………….....(1 mark)
2- Why did the physician ask the girl not to squeeze the abscess……………………………………..(1 mark)
3- Mention the sensory nerve supplyof the nose………………………………………………………….(1 mark)
_______________________________________________________________________________________

 QUESTION (2) (Neck& Cavities)………..………………(21 MARKS):
A- Describe the branches of the hypoglossal nerve (diagramnot needed).…………………………(4 marks)
B- Draw a diagram showing the relations of the thyroid gland lobes….………………….………..(4 marks)
C- Mention the boundaries and enumerate the contents of suboccipital triangle (diagram
needed)………………………………………………………………………………………………………......(5 marks)
D- Enumerate the structures on the lateral surface of the palatine tonsil (diagram needed). Mention its
surface anatomy……..………………………………………………………………………………………….(5 marks)
E- Problem solving (3 marks):
A 4 years old boy was admitted to emergency room suffering from suffocation after swallowing a shirt
button. After X ray examination ,the diagnosis was impaction of foreign body in the larynx.
1- Enumerate the arteries supplying of larynx and their origin....................................................(1 mark)
2- Mention sensory nerve supplyof the larynx…………………………………………………………….(1 mark)
3- Mention the effect of injury of recurrent laryngeal nerve……………………………………………...(1 mark)
_______________________________________________________________________________________

 QUESTION (3) (Neuroanatomy)………………………(22 MARKS):
A- Compare between dorsal and ventral spinocerebellar tracts (diagram not needed)……..........(6 marks)
B- Mention the structures in the rhomboid fossa (floor of 4th
ventricle) (diagramneeded)……....(6 marks)
C- Describe the relations of superior and medial surfaces of the thalamus (diagram needed)…..(6marks)
D- Mention the contents of the anterior limb and genu of the internal capsule (diagram not needed)
……………………………………………………………………………………………………………………...(4 marks)
1

2.  QUESTION (4) (Lower limb)…………..………………(22 MARKS):
A- Mention the origin, course and relations of the femoral nerve and enumerate its branches.(5 marks)
B- Mention origin, insertion, nerve supply and action of adductor magnus muscle (diagram not
needed)………………………………………………………………………………………………………….(4 marks)
C- Enumerate the arteries share in the anastomosis around the knee joint (diagram needed)..(5 marks)
D- Write a short note on deep fascia of the leg (fascia cruris), then, mention the site, attachments and
structures deep to the flexor retinaculum (diagram not needed)……………………………………(5 marks)
E- Problem solving (3 marks):
A 50 years old woman came to the hospital after noticing a lemon- sized swelling in the upper thigh. On
examination, the swelling was below and lateral to the pubic tubercle. The suspected diagnosis was
femoral hernia
1- What is the course of femoral hernia? ……..………..................................................................(1 mark)
2- Mention the surface anatomy of the femoral ring ……………………………………………………(0.5 mark)
3- Enumerate the coverings of femoral hernia…………………..……………………………………..(1.5 marks)
_______________________________________________________________________________________

 QUESTION (5) (Special Embryology)..……………..(13 MARKS):
A- Enumerate the derivatives of paramesonephric duct in male and female……………………….(4 marks)
B- Summarize the fate of the sinus venosus………………………………………..…………………….(5 marks)
C- Enumerate the results of rotation of stomach 90 degrees around its longitudinal axis……….(4 marks)
_______________________________________________________________________________________

 QUESTION (6): MCQ……………………………………(25 MARKS):
(25) Questions. Mark only the letter of chosen answer in the MCQ page of the answer paper
: 2014/6/6 ‫الجمعة‬ ‫يوم‬ ‫الطالب‬ ‫لجميع‬ ‫العملي‬ ‫االمتحان‬
-‫من‬1-250‫الساعة‬5‫و‬8‫صباحا‬
-‫من‬251-500‫الساعة‬11‫صباحا‬
-‫من‬501-750‫الساعة‬5‫و‬1‫ظهرا‬
-‫من‬751-‫الساعة‬ ‫الكشف‬ ‫آخر‬3‫ظهرا‬
‫االمتحان‬‫الشفوي‬‫ال‬ ‫يوم‬ ‫الطالب‬ ‫لجميع‬‫سبت‬7/6/2014:
-‫من‬1-250‫الساعة‬8‫صباحا‬
-‫من‬251-500‫الساعة‬10‫صباحا‬
-‫من‬501-753‫الساعة‬12‫ظهرا‬
-‫من‬754-‫الساعة‬ ‫الكشف‬ ‫آخر‬2‫ظهرا‬
-‫والحضور‬ ‫والعملية‬ ‫الشفوية‬ ‫االمتحانات‬ ‫أثناء‬ ‫األبيض‬ ‫البالطو‬ ‫بارتداء‬ ‫االلتزام‬ ‫الطالب‬ ‫جميع‬ ‫على‬‫في‬‫ا‬ ‫الموعد‬‫لمحدد‬
-‫مع‬ ‫وجوده‬ ‫ثبوت‬ ‫حالة‬ ‫وفى‬ ‫العملية‬ ‫االمتحانات‬ ‫أثناء‬ ‫المحمول‬ ‫التليفون‬ ‫اصطحاب‬ ‫باتا‬ ‫منعا‬ ‫ممنوع‬‫أي‬‫طالب‬‫يعتب‬‫ذلك‬ ‫ر‬
‫االمتحان‬ ‫حضور‬ ‫من‬ ‫ويحرم‬ ‫غش‬
With My Best Wishes
Chairmanof Department: Prof.Dr. Mona Zoair
2

3. QUESTION (6) MULTIPLE CHOICE QUESTIONS (25 MARKS)
 Mark only the letter of the chosen answer (A or B or C or D ) of
25 questions in the MCQ page at the end of the answer paper.
Choose the correct answer:
1- The nerve root of lesser occipital nerve is:
A) Ventral ramus of 2nd
cervical nerve B) Dorsal ramus of 2nd
cervical nerve
C) Ventral ramus of 3rd
cervical nerve D) Dorsal ramus of 3rd
cervical nerve
2- The following artery is a branch from third part of maxillary artery:
A) Buccal artery B) Greater palatine artery
C) Inferior alveolar artery D) Deep auricular artery
3- The following nerve is a branch of maxillary nerve in pterygopalatine fossa:
A) Posterior superior alveolar nerve B) Meningeal branch
C) Zygomatic nerve D) Middle superior alveolar nerve
4- Sphenomandibular ligament is attached to:
A) Angle of mandible B) lateral surface of neck of mandible
C) posterior end of mylohyoid line D) Lingula of mandibular foramen
5- The following is not a tributary of the cavernous sinus:
A) Superior petrosal sinus B) Sphenoparietal sinus
C) Central vein of retina D) Superior ophthalmic vein
6- The followinga are branches of nasociliary nerve EXCEPT:
A) Posterior ethmoidal nerve B) Anterior ethmoidal nerve
C) Supratrochlear nerve D) Infratrochlear nerve
7- The clavicular head of sternomastoid muscle arises from:
A) Anterior surface of medial 1/3 of clavicle B) Upper surface of medial 1/3 of clavicle
C) Anterior surface of medial 2/3 of clavicle D) Upper surface of medial 2/3 of clavicle
8- The following structure is not a content of the digastric triangle:
A) Submandibular salivary gland B) Submandibular lymph nodes
C) Facial artery D) Anterior jugular vein
9- The following structure does not pass between internal and external carotid arteries:
A) Stylopharyngeus muscle B) Pharyngeal branch of vagus nerve
C) Glossopharyngeal nerve D) Superior laryngeal branch of vagus nerve
10- The following are branches of middle cervical ganglion of sympathetic trunk:
A) Internal carotid nerve B) External carotid nerve
C) Thyroid branches D) Pharyngeal branches
11- Thyrocervical trunk gives the following branches EXCEPT :
A) Transverse cervical artery B) Deep cervical artery
C) Suprascapular artery D) Inferior thyroid artery
12- The following muscle protrude the tongue:
A) Genioglossus B) Hyoglossus
C) Styloglossus D) Palatoglossus
13- The posterior superior quadrant of the lateral nasal wall is supplied by the following artery:
A) Facial artery B) Sphenopalatine artery
C) Greater palatine artery D) Posterior ethmoidal artery
3

4. 14- Loss of sensation of pain and temperature is due to damage of:
A) Lateral corticospinal tract B) Ventral spinothalamic tract
C) Lateral spinothalamic tract D) Dorsal spinocerebellar tract
15- The medial lemniscus carries the following sensations:
A) Pain and temperature B) Proprioceptive sensations from the limbs and trunk.
C) Proprioceptive sensations from the head D) Auditory sensations
16- The cauda equine is made up of:
A) Roots of lumbar nerves only B) Roots of sacral and coccygeal nerves
C) Roots of sacral nerves only D) Roots of lumbar, sacral and coccygeal nerves
17- Which of the following tracts pass through the middle cerebellar peduncle?
A) Cortico-ponto-cerebellar fibres B) Reticulo- cerebellar fibres
C) Dorsal spino-cerebellar tract D) Ventral spino-cerebellar tract
18- The arterywhich lies in the insula of the brain is:
A) Anterior cerebral artery B) Superior cerebellar artery
C) Middle cerebral artery D) Posterior cerebral artery
19- Regarding the internal capsule, one is TRUE:
A) Is a thick band of commissural fibers B) Is formed of gray matter.
C) Contains descending fibers only. D) Corticospinal fibers pass in its posterior limb
20- The following artery shares in trochanteric anastomosis:
A) Acetabular branch of medial circumflex femoral artery
B) Ascending branch of medial circumflex femoral artery
C) Transverse branch of medial circumflex femoral artery
D) Transverse branch of lateral circumflex femoral artery
21- In the upper part of the back of the thigh, sciatic nerve is covered by :
A) Long head of biceps femoris muscle B) Gluteus maximus muscle
C) Semitendinosus muscle D) Semimembranosus muscle
22- The deepest structure in the popliteal fossa is:
A) Popliteal vein. B) Popliteal artery.
C) Medial popliteal nerve. D) Genicular branch of posterior division of obturator nerve
23- Actions of tibialis anterior are:
A) Eversion and dorsiflexion of foot. B) Inversion and dorsiflexion of foot.
C) Inversion and planter flexion of foot. D) Eversion and planter flexion of foot.
24- The following artery replaces the dorsalis pedis artery in 15% of people:
A) Circumflex fibular artery B) Malleolar branch of posterior tibial artery
C) Perforating branch of peroneal artery D) Calcanean branch of peroneal artery
25- Regarding the lateral meniscus of the knee joint, one statement is WRONG:
A) It is circular in shape
B) Its anterior horn is attached to the most anterior part of the anterior intercondylar area of the tibia
C) It is more mobile
D) It is less liable to injury
END OF THE EXAM
4

5. Answer Key For MCQ Questions
(Egyptian Anatomy Exam)
1- A)
2- B)
3- C)
4- D)
5- A)
6- C)
7- B)
8- D)
9- D)
10- C)
11- B)
12- A)
13- B)
14- C)
15- B)
16- D)
17- A)
18- C)
19- D)
20- B)
21- A)
22- B)
23- B)
24- C)
25- B)
12

6. ANATOMY DEPARTMENT:
MODEL ANSWER OF SECOND YEAR
FINAL ANATOMY EXAMINATION (Egyptians) 4/6/2014

 QUESTION (1) (Head)……(22 MARKS):
1- A- Draw a diagram showing venous drainage of the scalp and face. (5 marks)
Mention the differences between cut wounds in connective tissue layer of scalp
and aponeurosis of occipitofrontalis
-Cut wound involving connective tissue layer does not gap.
-The cut vessel in it cannot retract and leads to profuse bleeding.
- Cut wound involving epicranial apoeurosis gaps due to contraction of occipitofrontalis muscle
1

7. 1- B- Mention origin, insertion, nerve supply and action of medial pterygoid
muscle (diagram not needed) (5 marks)
 Origin:
Superficial head
Arises from the tuberosity of the maxilla.
Deep head
Arises from the medial surface of the lateral pterygoid plate and pterygoid fossa.
 Insertion:
It is inserted into the medial surface of the angle of the mandible below the mandibular foramen
and behind the mylohyoid groove.
 Nerve supply: By a branch from the trunk of mandibular nerve
 Action:
 The muscles of both sides
* Acting together : Protrusion and elevation of the mandible
* Acting alternatively : They produce side to side movement of the mandible
The muscle of one side acting alone:
- Pulls the mandible towards the opposite side
- Protrude and elevate the mandible.
______________________________________________________________________________
1- C- Enumeratenerves supplyingthe dura mater (diagram not needed) (4
marks)
Most of the supratentorial part :
- The ophthalmic nerve (Tentorial nerve).
The dura of the anterior cranial fossa :
1-Anterior ethmoidal nerve.
2-Posterior ethmoidal nerve.
The dura of the middle cranial fossa :
1- Nervous spinosus.
2- Meningeal branch of maxillary nerve
The dura of the posterior cranial fossa :
1-Meningeal branches of the 10th &12th cranial nerves
The dura around foramen magnum:
- 1st ,2nd & 3rd cervical nerves
__________________________________________________________________
1- D- Enumeratethe branches of ophthalmicartery (diagram needed)(5 marks)
1- Central artery of the retina
2- Lacrimal artery which gives lateral palpebral, muscular, recurrent meningeal and zygomatic
arteries
3- Supraorbital artery
4- Ciliary arteries;
-2 Long posterior ciliary arteries
-7 Short posterior ciliary arteries
- Anterior ciliary arteries
5- Ethmoidal arteries:
- Anterior ethmoidal artery
- Posterior ethmoidal artery
6- Meningeal branch
7- Muscular branches
8- Medial palpebral arteries
9- Supratrochlear artery (terminal branch)
10- Dorsal nasal artery (terminal branch)
2

8. 1- E- Problem solving(3 marks):
1- Dangerous triangle of the face or maxillofacial death pyramid is an area of facial skin bounded by
the nose, eye, and upper lip. (1 mark)
2- The physician asked the girl not to squeeze the abscess because Infection from this area may
spread through the superior ophthalmic vein to the cavernous sinus causing cavernous sinus
thrombosis. (1 mark)
3- The sensory nerve supply of the nose: (1 mark)
- Infratrochlear branch of nasociliary supplies upper 1/2 of the nose
- External nasal nerve branch of anterior ethmoidal nerve supplies lower 1/2 of the nose as far as
the tip
-Nasal branch of infraorbital nerve to the posterior part of side of the nose
3

9.  QUESTION (2) (Neck& Cavities)………..………………(21 MARKS):
2- A- Describe the branches of the hypoglossal nerve (diagram not needed).
(4 marks)
Fibres from C1
Meningeal branch
- To the dura of the posterior cranial fossa
Nerve to geniohyoid .
Nerve to thyrohyoid .
Descendens hypoglossi:
- Arises at the lower border of the posterior belly of digastric
- Descends on the surface of the internal carotid artery and continues on the common carotid
artery.
- It joins the descendens cervicalis (C2 & 3) to form the ansa cervicalis
- It supplies the infrahyoid muscles
Fibres from the hypoglossal nucleus:
 Muscular branches to all extrinsic and intrinsic muscles of the tongue except palatoglossus
( supplied by the cranial root of accessory nerve).
_____________________________________________________________________________
2- B- Draw a diagram showing the relations of the thyroid gland lobes.(4 marks)
4

10. 2- C- Mention the boundaries, roof, floor and enumerate the contents of
suboccipital triangle (diagram needed (5 marks)
 Boundaries:
Medially: Rectus capitis posterior major and minor.
 Inferolateral: Inferior oblique.
Superolateral: Superior oblique.
 Roof:
Semispinalis capitis
Longissmus capitis.
 Floor:
Posterior arch of atlas
Posterior atlanto-occipital membrane.
 Contents:
1-Vertebral artery (3rd part)
2-Suboccipital plexus of veins
3- Suboccipital nerve (C1)
4- Greater occipital nerve (C2).
5-Deep division of the descending branch of occipital artery.
______________________________________________________________________________
2- D- Enumerate the structures on the lateral surface of the palatine tonsil
(diagram needed). Mention its surface anatomy (5 marks)
 Capsule: Separates the tonsil from the superior constrictor of the pharynx
 Superior constrictor: Separates the tonsil from:
* The facial artery and its branches:
 Tonsillar artery
 Ascending palatine artery
 Para-tonsillar vein:
- Lie between the tonsil & superior constrictor
- It is a common source of haemorrhage in tonsillectomy.
 Glossopharyngeal nerve :
- Lies lateral to the superior constrictor muscle
 More laterally & postero-laterally lie the following:
- Styloid process if it is long.
- Stylopharyngeus muscle
- Styloglossus muscle
- Stylohyoid ligament.
- Ascending pharyngeal artery.
Surface anatomy of palatine tonsil:
It is marked by an oval area over the masseter muscle just antero-superior to the angle of the
mandible.
5

11. 3-E- Problem solving (3 marks):
1- The arteries supplying the larynx and their origin (1 mark)
- Superior laryngeal artery from superior thyroid artery
- Inferior laryngeal artery from inferior thyroid artery
2- Sensory nerve supply of the larynx (1 mark)
- Above the level of the vocal folds : is supplied by the internal laryngeal nerve a branch of the
superior laryngeal of vagus
- Below the level of the vocal folds : is supplied by the recurrent laryngeal nerve ; branch from the
vagus
3-Effect of injury of recurrent laryngeal nerve (1 mark)
- Unilateral paralysis:
- Vocal cord of the paralyzed side becomes immobile.Phonation is possible but the voice is
weak.
Bilateral paralysis:
- Vocal folds attain the cadaveric position. This results in dyspnea, stridor and loss of voice.
6

12.  QUESTION (3) (Neuroanatomy)………………………(22 MARKS):
3- A- Compare between dorsal and ventral spinocerebellar tracts (diagram not
needed) (6 marks)
1- Dorsal spinocerebellar tract 2- Ventral spinocerebellar tract:
First neurons:
 Include large cells in the dorsal root ganglia
with their peripheral and central processes
(from C8 to S3).
 The central processes synapse with the
cells of nucleus dorsalis of Clarke.
Second neurons:
 The nucleus dorsalis of Clarke.
 The cell axons ascends in the lateral white
column as the dorsal spinocerebellar tract,
up to the medulla oblongata to reach the
cerebellum via the inferior cerebellar
peduncle.
 Terminate ipsilaterally in the cortex of the
cerebellar vermis (anterior lobe).
First neurons;
 Include large cells in the dorsal root ganglia with
their peripheral and central processes. (from L1
to S2)
 The central processes synapse with the cells of
the spinal border nucleus.
Second neurons:
 The spinal border nucleus: Their axons cross
the median plane and ascend in the lateral
white column as the ventral spinocerebellar
tract, ascend in the brain stem to enter the
cerebellum via the superior cerebellar peduncle.
 Terminate contralaterally in the cortex of the
cerebellar vermis (anterior lobe).
____________________________________________________________________
3- B- Mentionthe structuresin the rhomboidfossa (floor of 4th
ventricle) (diagram
needed)….(6 marks)
Is formed by the posterior surface of both pons and upper1/2 of the medulla oblongata. The pontine
part is separated from the medullary part by the striae medullaris.
Is divided into right and left symmetrical halves by a median sulcus.
1- Median eminence (eminentia medialis):
Is an elevation that lies alongside the median sulcus and shows the followings:
a- Facial colliculus: lies in the pontine part and is formed by the abducent nucleus with the
looping fibres of facial nerve around it.
b- Hypoglossal trigone: lies in the medullary part and overlies the hypoglossal nerve nucleus.
2- Vestibular area:
-Large elevation that lies at the lateral angle of the rhomboid fossa and overlies the 4 vestibular
nuclei.
-Two depressions can be seen between the medial and lateral elevations:
a- Superior fovea; lies in the upper pontine part between the facial colliculus and vestibular area.
b- Inferior fovea; lies in the lower medullary part. It is triangular in outline. The hypoglossal
trigone lies medial to it, the vestibular area lateral to it and it overlies the dorsal nucleus of vagus
( vagal trigone).
7

13. 3- C- Describe the relations of superior and medial surfaces of the thalamus
(diagram needed)…(6marks)
Superior surface:
 It is related to the fornix which divides the superior surface into medial and lateral portions
- The medial portion: covered by tela choroidea of the lateral ventricle.
- The lateral portion: forms the floor of the central part of the lateral ventricle and is
overlapped by the choroid plexus of that ventricle. More laterally, it is related to the caudate
nucleus.
Medial surface:
 Constitutes the upper part of the lateral wall of the 3rd ventricle.
 Connected to the corresponding surface of the opposite thalamus by a band of grey matter
called the inter-thalamic adhesion.
 This surface is limited below by a curved ill-defined groove termed the hypothalamic sulcus
which separates it from the hypothalamus.
 This surface is limited above by a white band known as stria habenularis (stria medullaris)
which separates this surface from the medial surface and is covered by the ependyma of the 3rd
ventricle.
______________________________________________________________________________
3- D- Mention the contents of the anterior limb and genu of the internal capsule
(diagram not needed).(4 marks)
ANTERIOR LIMB : It contains the following fibres :
• Ascending fibres :
- Anterior thalamic radiation, from the anterior and medial thalamic nuclei to the cerebral cortex
(frontal lobe).
•Descending fibres :
- Frontopontine fibres ; from the frontal cortex to the pontine nuclei then they pass in the medial
third of the crus cerebri.
GENU : It contains the following fibres.
•Ascending fibres
- Part of the superior thalamic radiation ; from the postero ventral nuclei of the thalamus
(VPL & VPM) to the postcentral gyrus.
•Descending fibres :
 Cortico-bulbar tracts
8

14. QUESTION (4) (Lower limb)…………..………………(22 MARKS):
4- A- Mentionthe origin,courseand relations of the femoralnerveand enumerate
its branches.(5 marks)
 Origin:
- Arises inside the abdomen from the dorsal divisions of the ventral rami of L2,3,4 roots of lumbar
plexus.
 Course and relations:
- Begins in the abdomen deep to the psoas major muscle.
- It emerges from the lateral border of psoas major muscle and descends between it and iliacus
behind the fascia iliaca
- It leaves the abdomen deep to the inguinal ligament and enters the femoral triangle lateral to the
femoral artery (outside the femoral sheath).
-Ends 1 inch below the inguinal ligament by dividing into anterior and posterior divisions separated
by the lateral circumflex femoral artery.
 Branches:
Before it divides it gives 2 muscular branches:
1- To iliacus muscle: inside the abdomen.
2-To pectineus muscle : In the femoral triangle
Divisions:
 Anterior division :
Gives 1 muscular and 2 cutaneous branches:
- 1 Muscular branches to sartorius :
- 2 Cutaneous branches :
* Medial cutaneous nerve of the thigh:
* Intermediate cutaneous nerve of the thigh:
 Posterior division
Gives 4 muscular and 1 cutaneous.
- 4 Muscular branches : To the quadriceps femoris muscle
* Nerve to rectus femoris
* Nerve to vastus lateralis
* Nerve to vastus intermedius
* Nerve to vastus medialis
- 1 Cutaneous nerve. (Saphenous nerve: (L3,4).
________________________________________________________________________________
4- B- Mention origin, insertion, nerve supply and action of adductor magnus
muscle (diagram not needed).(4 marks)
 Origin:
 Pubic part : from the lower ½ of outer surface of pubic arch.
 Ischial part: from the lateral ½ of the lower area of the ischial tuberosity.
 Insertion:
 Pubic part : into :
-The medial lip of gluteal tuberosity.
-Linea aspera.
-Medial supracondylar ridge.
 Ischial part : into the adductor tubercle of the femur
 Nerve supply:
 Pubic part: supplied by the obturator nerve
 Ischial part: supplied by the sciatic nerve
 Action:
 Pubic part : Adducts the thigh and medially rotates it.
 Ischial part : Extends the hip joint during walking.
9

15. 4- C- Enumerate the arteries share in the anastomosis around the knee joint
(diagram needed)..(5 marks)
It is a rich anastomosis established between:
1. Genicular branches of popliteal artery.
2. Branches from femoral artery.
3. Branches from anterior & posterior tibial arteries.
 It is arranged as 2 longitudinal channels : .
 The medial channel is formed by:
 Superior medial genicular artery.
 Inferior medial genicular artery .
 Middle genicular artery.
 Articular branch of descending genicular artery of femoral artery
 The lateral longitudinal channel is formed by:
 Superior lateral genicular artery.
 Inferior lateral genicular artery .
 Descending branch of lateral circumflex femoral of profunda artery
 Anterior tibial recurrent of anterior tibial artery
 Posterior tibial recurrent of anterior tibial artery
 Circumflex fibular artery of posterior tibial artery
______________________________________________________________________________
4- D- Write a shortnote on deep fascia of the leg (fascia cruris),then,mention the
site, attachments and structures deep to the flexor retinaculum (diagram not
needed)(5 marks)
 It is very strong & tightly surrounds the leg, but does not cover the subcutaneous bony surfaces.
 It is attached to the anterior and medial borders of the tibia.
 Its part behind the knee forms the popIiteal fascia which is continuous with the fascia lata of the thigh
 Its part around the ankle joint is thickened to form the retinacula (flexor, extensor and peroneal)
 It gives anterior and posterior intermuscular septa, which are attached to the anterior and posterior borders
of the fibula respectively. These septa with the tibia and fibula divide the leg into 3 compartments (anterior,
lateral and posterior).
Flexor Retinaculum
 Site: Lies below and behind the medial malleolus
 Attachments:
- Above ; to the posterior border of medial malleolus.
- Below ; to the medial tubercle of calcaneous.
 Structures passing deep to it:
From medial to lateral
- Tibialis posterior tendon
- Flexor Digitorum longus tendon
- Posterior Tibial Vessels
- Posterior Tibial Nerve
- Flexor Hallucis longus tendon
_______________________________________________________________________________
4- E- Problem solving(3 marks):
1- The course of femoral hernia (1 mark): First downwards in femoral canal. Then, forward through the
saphenous opening. Finally, upwards and laterally in the superficial fascia.
2- The surface anatomy of the femoral ring.(0.5 mark): It is represented by an inch long horizontal line over
the inguinal ligament and an inch medial to the mid-inguinal point
3- The coverings of femoral hernia (1.5 marks):
1- Femoral septum (which closes femoral ring).
2- Fascia transversalis (anterior wall of femoral canal).
3- Cribriform fascia (roof of saphenous opening).
4- Superficial fascia.
5- Skin
10

16. 
 QUESTION (5) (Special Embryology)..……………..(13 MARKS):
5- A- Enumerate the derivatives of paramesonephric ductin male and female….(4
marks)
In Male: The paramesonephric duct degenerates except:
- Its cranial end to form the appendix of the testis.
-Its caudal part develops into the prostatic utricle.
In Female:
- the upper vertical and middle horizontal parts of the duct form the uterine tubes.
- The lower vertical parts of both ducts fuse together in the middle line to form a single canal called
the uterine canal. It forms the uterus and the upper 1/3 of the vagina.
________________________________________________________________________________
5- B- Summarize the fate of the sinus venosus… (5 marks)
1. Right horn will be incorporated into the right atrium to form the smooth part (sinus venarum).
2. Right common cardinal vein will form the lower part of superior vena cava.
3. The opening of the right vitelline vein will form the opening of inferior vena cava.
4. The right umbilical vein will disappear.
5. The body and left horn will form the coronary sinus.
6. The left common cardinal vein will form the oblique vein of left atrium (Marshal).
7. The left umbilical and vitteline veins will lose communication with the sinus.
8. The upper part of the right venous valve will form the crista terminalis.
9. The lower part of right venous valve will form the valves of I.V.C and coronary sinus.
10. The left venous valve will be incorporated with the interatrial septum.
______________________________________________________________________________
5- C- Enumerate the results of rotation of stomach 90 degrees around its
longitudinal axis (4 marks)
1. The left surface becomes anterior and the right surface becomes posterior.
2. The left vagus nerve is now called anterior gastric nerve and the right vagus nerve is called the
posterior gastric nerve.
3. The posterior wall of the stomach grows faster than the anterior portion and this results in the
formation of the greater and lesser curvatures.
4. Rotation of stomach will pull the dorsal mesogastrium to the left. This movement, aids in the
formation of the omental bursa (lesser sac).
11

17. Second Year Final Anatomy Exam. (Malaysians)Tanta University
Faculty of Medicine Number of Questions: 6
Anatomy Department Time Allowed: 3 Hours
4/6/2014 Total: 125 Marks
Very Important:each partof question mustbe written in a separate page

 QUESTION (1) (Head)…………………………………….(22 MARKS):
A- Enumerate the branches of facial nerve and their course in the face (diagram not
needed)……..………………………………………………………………………………………….(5 marks)
B- Mention the length, course and surface anatomy of parotid duct (diagram needed).(6 marks)
C- Draw a diagram showing the pterygoid venous plexus …………………………………(5 marks)
D- Enumerate nerve supply and actions of extrinsic muscles of the orbit (diagram not
needed)………………………………………………………………………………………………...(6 marks)
______________________________________________________________________________
 QUESTION (2) (Neck& Cavities)………..………………(21 MARKS):
A- Draw a diagram showing the boundaries and contents of the posterior triangle……(4 marks)
B- Discuss the course of the lingual nerve in the submandibular region…………..........(4 marks)
C- Mention the course and enumerate the branches of external carotid artery (diagram not
needed)………………………………………………………………………………………………...(5 marks)
D- Enumerate the blood supply, lymphatic drainage and verve supply of the larynx (diagram
not needed) Mention the effects of recurrent laryngeal nerve lesions……………………(5 marks)
E- Problem solving (3 marks):
A 40 years old female went to the physician complaining of a swelling at the front of the neck
which moves up and down with swallowing. After examination, the diagnosis was thyroid
gland tumor.
1- Mention the anastomosis in the thyroid gland……………………….……………………….(1 mark)
2- Mention the lymphatic drainage of thyroid gland……………………………………………(1 mark)
3- Mention the posterior relation of thyroid gland isthmus……………….………………… (1 mark)
________________________________________________________________________________
 QUESTION (3) (Neuroanatomy)………………………(22 MARKS):
A- Mention the course of lateral spinothalamic tract (diagram not needed)……………...(6 marks)
B- Enumerate the structures present in the floor of fourth ventricle (diagram needed).(5 marks)
C-Mention the boundaries and contents of the interpeduncular fossa (diagram
needed)………………………………………………………………………………………………...(6 marks)
D- Mention the ascending and descending fibres in the anterior and posterior limbs of internal
capsule (diagram not needed)……………………………………………………………………(5 marks)
1

18.  QUESTION (4) (Lower limb)…………..………………(22 MARKS):
A- Enumerate the boundaries of the femoral triangle (diagram needed)………………….(4 marks)
B- Enumerate the muscles and nerves undercover of gluteus maximus muscle (diagram not
needed)……………………………………………………………………………………………..…..(5marks)
C- Mention the branches of the popliteal artery (diagram needed)………………………..(5 marks)
D- Mention the site and attachments of superior extensor retinaculum and enumerate the
structures deep to it (diagram not needed)………………………………….…………………(5 marks)
E- Mention the surface anatomy of the femoral artery (diagram not needed)……………(3 marks)
_________________________________________________________________________________
 QUESTION (5) (Special Embryology)..……………..(13 MARKS):
A- Enumerate the factors affecting the descent of testis…….………………………………(4 marks)
B- Mention in table the fate of the five dilatations of the heart tube………………………..(5 marks)
C- Enumerate the skeletal and muscular derivatives of the first pharyngeal arch………(4 marks)
_________________________________________________________________________________
 QUESTION (6): MCQ……………………………………(25 MARKS):
(25) questions. Mark only the letter of chosen answer in the MCQ page of the answer paper
Practical examination:
Friday 6/6/2014 at 3 o'clock in the dissecting room
Oral Examination:
Saturday 7/6/2013 at 2 o'clock in the dissecting room
NB: -All students should attend oral and practical examinations with white coat
-All the students should notcarry mobile phone duringpracticalexamination
With My Best Wishes
Chairmanof Department: Prof.Dr. Mona Zoair
2

19. QUESTION (6) MULTIPLE CHOICE QUESTIONS (25 MARKS)
 Mark only the letter of the chosen answer (A or B or C or D ) of
25 questions in the MCQ page at the end of the answer paper.
Choose the correct answer:
1- The nerve root of lesser occipital nerve is:
A) Ventral ramus of 2nd
cervical nerve B) Dorsal ramus of 2nd
cervical nerve
C) Ventral ramus of 3rd
cervical nerve D) Dorsal ramus of 3rd
cervical nerve
2- Regarding the parotid duct, one statement is WRONG:
A) it runs over masseter muscle B) It lies between buccal and mandibular branches of facial nerve
C) It is about 5 cm long D) It opens in vestibule of mouth opposite upper 2nd
molar tooth
3- The following nerve is a branch of maxillary nerve in pterygopalatine fossa:
A) Posterior superior alveolar nerve B) Meningeal branch
C) Zygomatic nerve D) Middle superior alveolar nerve
4- Depression of mandible is done by:
A) Masseter B) Medial pterygoid muscle
C) Temporalis D) Lateral pterygoid muscle
5- The following is not a tributary of the cavernous sinus:
A) Superior petrosal sinus B) Sphenoparietal sinus
C) Central vein of retina D) Superior ophthalmic vein
6- The inferior division of oculomotor nerve supplies the following muscles EXCEPT:
A) Inferior oblique B) Inferior rectus
C) Superior oblique D) Medial rectus
7- The clavicular head of sternomastoid muscle arises from:
A) Anterior surface of medial 1/3 of clavicle B) Upper surface of medial 1/3 of clavicle
C) Anterior surface of medial 2/3 of clavicle D) Upper surface of medial 2/3 of clavicle
8- The following structure is not a content of the carotid triangle:
A) internal jugular vein B) internal carotid artery
C) vagus nerve D) Anterior jugular vein
9- The following nerve passes between internal and external carotid arteries:
A) Hypoglossal nerve B) External laryngeal nerve
C) Glossopharyngeal nerve D) Superior laryngeal branch of vagus nerve
10- The following is branch of superior cervical ganglion of sympathetic trunk:
A) Internal carotid nerve B) Ansa subclavia
C) Thyroid branches D) Middle cardiac branch
11- Thyrocervical trunk gives the following branches EXCEPT :
A) Transverse cervical artery B) Deep cervical artery
C) Suprascapular artery D) Inferior thyroid artery
12- The following muscle protrude the tongue:
A) Genioglossus B) Hyoglossus
C) Styloglossus D) Palatoglossus
13- The posterior superior quadrant of the lateral nasal wall is supplied by the following artery:
A) Facial artery B) Sphenopalatine artery
C) Greater palatine artery D) Posterior ethmoidal artery
3

20. 14- Loss of sensation of pain and temperature is due to damage of:
A) Lateral corticospinal tract B) Ventral spinothalamic tract
C) Lateral spinothalamic tract D) Dorsal spinocerebellar tract
15- Regarding the blood supply of the spinal cord, one is TRUE:
A) The anterior spinal artery is a branch of the vertebral artery
B) The posterior spinal artery is a branch of the ascending cervical artery
C) All the radicular arteries arise from the descending aorta
D) All the above.
16- Regarding the corticospinal tract, one is TRUE:
A) Its first neurons are pyramidal cells in motor and premotor areas of the cerebral cortex
B) 80% of fibres decussate at the open medulla.
C) Runs in the anterior limb of the internal capsule
D) Lateral corticospinal tract relay on anterior horn cells of the same side of the spinal cord.
17- Which of the following tracts pass through the superior cerebellar peduncle?
A) Ventral spino-cerebellar fibres B) Reticulo- cerebellar fibres
C) Dorsal spino-cerebellar tract D) Olivo-cerebellar fibres
18- The followings are opercula of the insula EXCEPT:
A) Frontoparietal operculum B) Frontal operculum
C) Occipital operculum D) Temporal operculum
19- The circle of Willis is formed of the following arteries EXCEPT:
A) Anterior communicating artery B) Posterior communicating artery
C) Posterior cerebral artery D) Middle cerebral artery.
20- All the followings form boundaries of adductor canal EXCEPT:
A) Anterolateral wall by vastus lateralis B) Anteromedial wall by strong sheet of fascia
C) Anterolateral wall by vastus medialis D) Posterior wall by adductor longus and magnus
21- The following cutaneous nerve is not a branch of the fempral nerve :
A) Medial cutaneous nerve of the thigh B) Intermediate cutaneous nerve of the thigh
C) Lateral cutaneous nerve of the thigh D) Saphenous nerve
22- The deepest structure in the popliteal fossa is:
A) Popliteal vein. B) Popliteal artery.
C) Medial popliteal nerve. D) Genicular branch of posterior division of obturator nerve
23- Regarding events occurring at the lower border of popliteus, one is WRONG:
A) Popliteal artery ends by dividing into anterior and posterior tibial arteries.
B) Popliteal vein begins.
C) Medial popliteal nerve becomes anterior tibial nerve.
D) Origin of soleus muscle.
24- The following is a branch of dorsalis pedis artery:
A) Anterior medial malleolar artery B) Anterior lateral malleolar artery
C) Anterior tibial recurrent artery D) Lateral tarsal artery
25- All are the branches of planter arch, EXCEPT:
A) Superficial digital arteries B) 4 plantar metatarsal arteries
C) Posterior perforating arteries D) Plantar digital artery for lateral side of little toe
END OF THE EXAM
4

21. Answer Key For MCQ Questions
(Malaysian Anatomy Exam)
1- A)
2- B)
3- C)
4- D)
5- A)
6- C)
7- B)
8- D)
9- C)
10- A)
11- B)
12- A)
13- B)
14- C)
15- A)
16- A)
17- A)
18- C)
19- D)
20- A)
21- C)
22- B)
23- C)
24- D)
25- A)
11

22. ANATOMY DEPARTMENT:
MODEL ANSWER OF SECOND YEAR
FINAL ANATOMY EXAMINATION (Malaysians) 4/6/2014
 QUESTION (1) (Head)…………………………………….(22 MARKS):
1- A- Enumerate the branches of facial nerve in the face and mention how they
emerge from the parotid gland (diagram not needed)..(5 marks)
1- Temporal :Emerges from the upper part of anterior border of the gland and ascends crossing
the zygomatic arch.
2- Zygomatic :Emerges from the anterior border of the gland and runs forwards along the
zygomatic arch.
3- Buccal :Emerges from the anterior border of the gland and runs close to the parotid duct to the
angle of mouth.
4- Mandibular Emerges from the anterior border of the gland and runs along the mandible.
5- Cervical Emerges from the lower part of anterior border of the gland and descends to the neck
just below the mandible
_________________________________________________________________________________
1-B- Mention the length, course and surface anatomy of parotid duct (diagram
needed).(6 marks)
It is about 5 cm long.
Appears at the anterior border of the gland at the level of the lobule of the ear.
It runs forwards over the masseter below the accessory parotid gland and transverse facial
artery.
It lies between 2 branches of the facial nerve zygomatic branch (above) and buccal branch
(below)
At the anterior border the masseter it turns medially to open in the vestibule of the mouth
piercing the following structures in succession:
- Buccal pad of fat
- Buccopharyngeal fascia
- Buccinator muscle
- Buccal mucous membrane.
It then opens in the vestibule of the mouth upon a small papilla opposite the 2nd upper molar
tooth.
Surface anatomy:
It corresponds to the middle third of a line drawn between the following 2 points:
1- A point at the lower border of the tragus of auricle.
2- A point midway between the ala of the nose and the upper labial margin.
1

23. 1- C- Discuss the formation, end and communications of pterygoid venous
plexus (diagram needed) (5 marks)
 This plexus is situated in the infratemporal region around the lateral pterygoid muscle.
 It receives the veins which accompany the branches of the maxillary artery.
 The posterior end of the plexus is drained through a short maxillary vein .
 It communicates with:
1- Anterior facial vein through the deep facial vein.
2- Cavernous sinus by emissary veins which pass through foramen oval, foramen lacerum and
emissary sphenoidal foramen.
3- Pharyngeal plexus.
4- Inferior ophthalmic vein through the inferior orbital fissure
____________________________________________________________
1-D- Enumerate nerve supply and actions of extrinsic muscles of the orbit
(diagram not needed)… (6 marks)
-Recti muscles:
 Nerve supply:
- The superior rectus is supplied by the superior division of oculomotor nerve.
- The inferior & medial recti are supplied by the inferior division of oculomotor nerve.
- The lateral rectus is supplied by the abducent nerve.
 Action:
- Superior rectus directs the pupil upwards and medially.
- Inferior rectus directs the pupil downwards and medially.
- Lateral rectus directs the pupil laterally.
- Medial rectus directs the pupil medially.
-Oblique muscles:
Superior oblique
 Nerve supply: Trochlear nerve.
 Action:
- Directs the pupil downwards and laterally.
- Simultaneous contraction with the inferior rectus moves the eyeball directly downwards
Inferior oblique
 Nerve supply: Inferior division of oculomotor nerve.
 Action:
- Directs the pupil upwards and laterally.
- Simultaneous contraction with the superior rectus moves the eye ball directly upwards.
-Levator palpebrae superioris
Nerve supply:
- Superior division of oculomotor nerve.
- The inferior lamella contains smooth muscle fibers which are supplied by sympathetic fibres
from the superior cervical sympathetic ganglion.
Action:
- Elevation of the upper eyelid and superior fornix of the conjunctiva.
- In stress conditions (sympathetic overstimulation) the upper eyelid is strongly elevated and
the palpebral fissure is widened due to contraction of the smooth muscle fibers in the levator
palpebrae superioris
2

24.  QUESTION (2) (Neck& Cavities)………..………………(21 MARKS):
2-A- Draw a diagram showing the boundaries and contents of the posterior
triangle……(4 marks)
3

25. 2-B- Discuss the course of the lingual nerve in the submandibular region….
(4 marks)
It passes on the inner aspect of the mandible grooving the alveolar margin close to the medial
side of the root of the 3rd molar tooth.
 Then, it reaches the floor of the mouth where it is related to the lateral surface of the
hyoglossus muscle. Here :
*The submandibular ganglion is suspended from it
*It receives a communication from the hypoglossal nerve
 Near the anterior border of the hyoglossus it hooks around the submandibular duct coming
from its lateral aspect then below and ascend medial to it.
 Both the nerve and duct then pass upwards under cover the sublingual gland on the
genioglossus muscle.
 It ends by dividing into its terminal branches
________________________________________________________________________________
2- C- Mention the course and enumerate the branches of external carotid artery
(diagram not needed)..(5 marks)
Course
 One of the terminal branches of the common carotid artery
 Begins at the upper border of thyroid cartilage opposite the disc between the 3rd and 4th
cervical vertebrae
 Ascends upwards and forwards superficial to the internal carotid artery in the carotid
triangle
 It leaves the triangle by passing under cover of the posterior belly of digastric muscle
 It pierces the postero-medial surface of the parotid gland and ascends within its substance
behind the ramus of the mandible.
 Ends in the substance of parotid gland behind the neck of the mandible by dividing into
maxillary and superficial temporal arteries.
Branches
 From the anterior aspect of the artery:
-Superior thyroid artery
-Lingual artery
-Facial artery
 From the posterior aspect of the artery:
-Occipital artery
-Posterior auricular artery
 From the medial aspect of the artery:
-Ascending pharyngeal artery
 Terminal branches
-Superficial temporal artery
-Maxillary artery
4

26. 2- D- Enumerate the blood supply, lymphatic drainage and verve supply of the
larynx (diagram not needed) Mention the effects of recurrent laryngeal nerve
lesions (5 marks):
 Blood supply of larynx
Superior laryngeal branch of superior thyroid artery
Inferior laryngeal branch of inferior thyroid artery
 Lymphatic drainage of larynx
Above the level of vocal cords drains to the upper deep cervical lymph nodes
Below the level of vocal cords drains to the prelaryngeal, pretracheal and lower deep cervical
lymph nodes
 Nerve supply of larynx
Motor
ALL the intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve
EXCEPT the cricothyroid which is supplied by the external laryngeal nerve
Sensory :
Above the level of the vocal folds : is supplied by the internal laryngeal nerve ; a branch of the
superior laryngeal of vagus
 Below the level of the vocal folds : is supplied by the recurrent laryngeal nerve ; a branch from
the vagus
Effect of injury of recurrent laryngeal nerve
- Unilateral paralysis:
- Vocal cord of the paralyzed side becomes immobile.Phonation is possible but the voice is
weak.
-Bilateral paralysis:
- Vocal folds attain the cadaveric position. This results in dyspnea, stridor and loss of voice.
_______________________________________________________________________________
2- E- Problem solving (3 marks):
1- Mention the anastomosis in the thyroid gland.(1 mark)
- Between the superior thyroid branch of external carotid artery and inferior thyroid branch of
subclavian artery.
2- Mention the lymphatic drainage of thyroid gland (1 mark)
- - Mainly into the deep cervical lymph nodes.
- -Few lymphatics drain into the paratracheal , pretracheal & prelaryngeal lymph nodes.
3- Mention the posterior relation of thyroid gland isthmus (1 mark)
- The 2 ,3 & 4 tracheal rings.
5

27.  QUESTION (3) (Neuroanatomy)………………………(22 MARKS):
3-A- Mentionthe courseof lateralspinothalamic tract (diagram notneeded).
(6 marks)
First neurons:
 Are found in the dorsal root ganglia at all cord levels.
 Their axons enter the dorsal horn where they usually synapse with the second neurons at the
same segment of entry. However, they may ascend one or two segments before they synapse
forming Lissauer's tract at the tip of the dorsal horn.
Second Neurons:
 Are found in the dorsal horn (Substantia gelatinosa of Rolandi) and give rise to axons that usually
cross the median plane at once just in front of the central canal decussating with the corresponding
fibers of the other side. However, they may ascend one or two segments before crossing.
 After crossing they ascend in the lateral white column of the spinal cord forming the lateral
spinothalamic tract.
 In the brain stem the tract joins the spinal lemniscus. It then terminates contralaterally in the VPL
nucleus of the thalamus.
Third neurons:
 The neurons are present in the VPL nucleus of thalamus.
 They project via the posterior limb of internal capsule to the postcentral gyrus (areas 1,2 & 3).
_________________________________________________________________________________
3- B- Enumeratethe structurespresentin the floor of fourth ventricle (diagram
needed).(5 marks)
 Is formed by the posterior surface of both pons and upper1/2 of the medulla oblongata. The
pontine part is separated from the medullary part by the striae medullaris.
 Is divided into right and left symmetrical halves by a median sulcus.
1- Median eminence (eminentia medialis):
Is an elevation that lies alongside the median sulcus and shows the followings:
c- Facial colliculus: lies in the pontine part and is formed by the abducent nucleus with the
looping fibres of facial nerve around it.
d- Hypoglossal trigone: lies in the medullary part and overlies the hypoglossal nerve nucleus.
2- Vestibular area:
-Large elevation that lies at the lateral angle of the rhomboid fossa and overlies the 4 vestibular
nuclei.
-Two depressions can be seen between the medial and lateral elevations:
a- Superior fovea; lies in the upper pontine part between the facial colliculus and vestibular area.
b- Inferior fovea; lies in the lower medullary part. It is triangular in outline.
-The hypoglossal trigone lies medial to it, the vestibular area lateral to it and it overlies the
dorsal nucleus of vagus ( vagal trigone).
6

28. 3-C- Mention the boundaries and contents of the interpeduncular fossa
(diagram needed) (6 marks)
Boundaries:
- Anteriorly: optic chiasma
- Posteriorly: upper border of the basilar part of the pons
- Anterolaterally: optic tract
- Posterolaterally: crus cerebri.
Contents: from before backwards
1-Tuber cinerum:- It's a slightly raised part just behind the optic chiasma.
- The infundibulum is attached to it and extends to the
posterior lobe of the pituitary gland.
2- Two mamillary bodies:- situated behind the tubercinerum.
3- Posterior perforated substance:- It's an area of grey matter pierced by the central branches of
the posterior cerebral arteries.
4- Oculomotor nerves:- They emerge from the medial aspect of the 2 crura
cerebri.
5- This fossa lodges the arteries of the circle of Willis.
_________________________________________________________________________________
3- D- Mentionthe ascendingand descending fibres in the anterior and posterior
limbs of internal capsule (diagram not needed)… (5 marks)
ANTERIOR LIMB :
• Ascending fibres :
- Anterior thalamic radiation, from the anterior and medial thalamic nuclei to the cerebral cortex
(frontal lobe).
•Descending fibres :
- Frontopontine fibres ; from the frontal cortex to the pontine nuclei then they pass in the medial
third of the crus cerebri.
POSTERIOR LIMB :
•Ascending fibres :
- Superior thalamic radiation; carrying general sensation from the posterior ventral thalamic nuclei
(VPL & VPM) to the postcentral gyrus .
•Descending fibres :
- Corticospinal fibres ; from the precentral gyrus (motor area) to the anterior horn cells of the spinal
cord. The fibres to the upper limb lie anteriorly followed by those to the trunk and the fibres to the
lower limb lie most posteriorlly.
- Corticorubral fibres ; from the premotor area of the frontal lobe (area 6) to the red nucleus
(extrapyramidal fibres).
7

29.  QUESTION (4) (Lower limb)…………..………………(22 MARKS):
4- A- Enumerate the boundaries of the femoral triangle (diagram needed)
(4 marks)
 Laterally:
Medial border of sartorius muscle.
 Medially:
Medial border of adductor longus muscle.
 Base:
It is formed by the inguinal ligament extending between the anterior superior iliac spine & the
pubic tubercle.
 Apex:
It is formed by the crossing of sartorius on the adductor longus muscle. Here it is continuos with
the adductor canal
_______________________________________________________________________________
4- B- Enumeratethe muscles and nervesundercover of gluteus maximus muscle
(diagram not needed).(5 marks)
Muscles
 Gluteus medius and minimus.
 Piriformis with the structures above and below it.
 Tendon of obturator internus and the 2 gemelli
 Quadratus femoris muscle.
 Origin of hamstring muscles

Nerves
 Sciatic nerve.
 Superior and inferior gluteal nerves.
 Pudendal nerve.
 Nerve to obturator internus
 Nerve to quadratus femoris.
 Posterior cutaneous nerve of the thigh
________________________________________________________________________________
4- C- Mention the branches of the popliteal artery (diagram needed) (5 marks)
 Muscular branches to the hamstrings and calf muscles.
 5 genicular branches.
 Superior medial genicular artery
Winds above medial femoral condyle.
 Superior lateral genicular artery
Winds above lateral femoral condyle.
 Inferior medial genicular artery
Winds below medial tibial condyle
 Inferior lateral genicular artery
Winds below lateral tibial condyle
 Middle genicular artery
Pierces the back of the capsule of knee joint with the genicular branch of posterior division of
obturator nerve
 Sural artery: Small cutaneous branch accompanying the sural nerve.
 Two terminal branches: Anterior and posterior tibial arteries.
8

30. 4- D- Mention the site and attachments of superior extensor retinaculum and
enumerate the structures deep to it (diagram not needed)… (5 marks)
Site: Immediately above the ankle joint
Attachments:
Medially: to the lower inch of anterior border of tibia.
Laterally: to the lower inch of anterior border of fibula.
Structures deep to it:
-Tibialis anterior muscle
- Extensor hallucis longus
- Anterior tibial vessels
- Anterior tibial nerve
- Extensor digitorum longus
-Peroneus tertius
________________________________________________________________________________
4- E- Mentionthe surface anatomy of the femoral artery (diagram not needed)…
(3 marks)
It is represented by the upper 2/3 of a line joining the following 2 points:
1st : Mid-inguinal point
2nd : Adductor tubercle
-The upper half of this line corresponds to the femoral artery in the femoral triangle.
- The lower half of this line corresponds to the femoral artery in the adductor canal.
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

31.  QUESTION (5) (Special Embryology)..……………..(13 MARKS):
5- A- Enumeratethe factors affecting the descentof testis (4 marks)
1- Differential growth of the posterior abdominal wall and related structures.
2- Stimulating effects of androgens and gonadotrophins.
3- Normal herniation under increased intra-abdominal pressure.
4- The exact role of the gubernaculum in the final descent of the testis to scrotum is still unknown.
It may become shortened and thickened or it may keep the path of the descent open
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5- B- Mentionin table the fate of the five dilatations of the hearttube… (5 marks)
Fate of the five dilatations of the heart tube
Embryonic Dilatation Adult Structure
Truncus arteriosus
Proximal part of ascending aorta
Proximal part of pulmonary trunk
Bulbus cordis
Smooth part of right ventricle
(infundibulum)
Smooth part of left ventricle
(aortic vestibule)
Primitive ventricle Trabeculated part of right
ventricle
Trabeculated part of left
ventricle
Primitive atrium Trabeculated part of right atrium
Trabeculated part of left atrium
Sinus venosus
Smooth part of right atrium
(sinus venarum)
Coronary sinus
Oblique vein of left atrium
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5- C- Enumeratethe skeletaland muscular derivatives of the first pharyngeal
arch (4 marks)
 The skeletal derivatives of the first arch are:
1. Malleus.
2. Incus
3. Sphenomandibular ligament.
4. Mandible by the mesodermal condensation around Meckel’s cartilage.
 The muscle derivatives of the first arch are:
1.Muscles of mastication
2.Anterior belly of digastric.
3.Mylohyoid.
4.Tensor palati.
5.Tensor tympani.
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