In a medial medullary syndrome that involves a left-sided branch of the anterior spinal artery, which of the following deficits is seen?
Answer(s): C
A vascular lesion affecting the left caudal medulla involves the left medial lemniscus, left hypoglossal nerve fibers, and the left medullary pyramid. Involvement of the left medial lemniscus produces somatosensory deficits involving the right side of the body. Damage to the left hypoglossal nerve would result in deviation of the protruded tongue to the left (and other lower motoneuron signs), and damage to the left pyramid results in right hemiplegia (choices A and B involve incorrect combinations) along with other upper motoneuron signs. Choices D and E are incorrect because they fail to combine involvement of the tongue and contralateral hemiplegia.
A neurologist is performing the neurological examination on a patient who recently suffered a head trauma. You note that, as part of the examination, she uses a cotton swab to touch the upper part of the auricle, the external auditory meatus, and the lobule. The external auditory meatus of the ear is innervated by which of the following?
Answer(s): A
The vagus (tenth cranial) nerve innervates the external auditory meatus of the ear. The great auricular nerve (choice B) innervates the lobule of the auricle and the auriculotemporal nerve (choice C), the superior aspect of the auricle. In fact, a sensory test which includes these three parts of the ear tests the integrity of the trigeminal (fifth cranial) nerve by the auriculotemporal nerve, the vagus (tenth cranial) nerve by its branch innervating the auditory meatus, and spinal nerves C2-3 by their great auricular branch. The test thus covers the upper and lower medulla and the upper spinal cord. The greater occipital nerve (choice D) is a branch of the cervical plexus originating from C2 and innervates the scalp of the back of the head.The facial (seventh cranial) nerve provides only motor innervation to the face and scalp areas.
A 48-year-old male patients is brought to the emergency room because of intense pain of the right face and neck with transient visual loss of the right eye. On examination, the patient has palsy of the oculomotor nerve on the right side with resulting diplopia, along with a right lateralized painful Horner syndrome. This constellation of signs is suggestive of a cervical carotid dissection, which is a separation of the arterial tunical intima from the subjacent tunica media. Which numbered structure in following figure, is the tunica intima?
Answer(s): D
Arrow 3 points to the tunica intima. The carotid artery is an elastic artery, which contains the following layers aside from the tunica intima: Tunica externa (arrow 1), and tunica media (arrow 5). In a carotid dissection, the tunica intima can elevate or separate from the tunica media with accompanying hemorrhage of the arterial wall. The most common clinical signs are ophthalmological manifestations including painful Horner syndrome, palsy of the oculomotor nerve, diplopia, and transient monocular visual loss. Arrow 2 points to a vasa vasorum, vessels which nourish the thick wall of the aorta. Arrow 4 points to the adipose tissue in the tunica externa.
The structure indicated by arrow 2 in following figure, is which of the following?
This axial scan is at the level of the orbits as indicated by the insert at the bottom right and the eyeballs in the orbits. Arrow 2 points to the ethmoidal sinus located medial to the orbits. The sinus is divided into compartments by the air cells. The maxillary sinus (choice D) and the inferior nasal meatus (choice B) are located inferior to the level of this scan and are not seen. The sphenoidal sinus (choice E) is indicated by arrow 3 and the infratemporal fossa (choice C) by arrow 1.
A stroke resulting from obstruction of the structure indicated by arrow 1 in following figure, may result in ischemia in which of the following brain regions?
Arrow 1 points to the right internal carotid artery which supplies the anterior and middle cerebral arteries in the brain. The territory of the right anterior cerebral artery includes the rightmedial aspect of the frontal lobe, which will be affected by obstruction of the internal carotid artery. Broca's (choice A) and Wernicke's (choice E) areas are located in the majority of the population in the left cerebral hemisphere and are supplied by the left middle cerebral artery from the left internal carotid artery. They will not be affected in this case. The cerebellum (choice B) and pons (choice D) receive their blood supply from the basilar artery (arrow 2) which is formed from the vertebral arteries.
Share your comments for USMLE STEP1 exam with other users:
this is very helpful content
please provide the dumps
it is amazing
quesion 178 about "a banking system that predicts whether a loan will be repaid is an example of the" the answer is classification. not regresion, you should fix it.
please upload apache spark dumps
q14 is b&c to reduce you will switch off mail for every single alert and you will switch on daily digest to get a mail once per day, you might even skip the empty digest mail but i see this as a part of the daily digest adjustment
i think it is good question
good for students who wish to give certification.
is there a google drive link to the images? the links in questions are not working.
very promising, looks great, so much wow!
i scored 87% on the az-204 exam. thanks! i always trust
good need more
sample questions seems good
huawei is ok
good one nice
please continue
this exam dumps just did the job. i donot want to ruffle your feathers but your exam dumps and mock test engine is amazing.
nice questions
the explanation are really helpful
just passed my exam yesterday on my first attempt. these dumps were extremely helpful in passing first time. the questions were very, very similar to these questions!
cosmos db is paas not saas
what is the percentage of common questions in gcp exam compared to 197 dump questions? are they 100% matching with real gcp exam?
not able to see questions
by far one of the best sites for free questions. i have pass 2 exams with the help of this website.
excellent question bank.
it really helped
excelent material
the new versoin of this exam which i downloaded has all the latest questions from the exam. i only saw 3 new questions in the exam which was not in this dump.
question 8 - can cloudtrail be used for storing jobs? based on aws - aws cloudtrail is used for governance, compliance and investigating api usage across all of our aws accounts. every action that is taken by a user or script is an api call so this is logged to [aws] cloudtrail. something seems incorrect here.
question 13 tda - c01 answer : quick table calculation -> percentage of total , compute using table down
pls share teh dump
question 44 answer is user risk
please post the questions for preparation
thanks for the questions