This document contains a final anatomy exam for second year medical students in Malaysia. The exam consists of 6 questions worth a total of 125 marks, covering various anatomical regions and topics. Question 1 focuses on head anatomy, Question 2 covers neck and cavities, Question 3 is on neuroanatomy, Question 4 addresses the lower limb, and Question 5 involves special embryology. The exam concludes with 25 multiple choice questions worth 25 marks.

1. Year Final Anatomy Exam. (Malaysians)SecondUniversityTanta
Faculty of Medicine Number of Questions: 6
Anatomy Department Time Allowed: 3 Hours
29/9/2013 Total: 125 Marks
Very Important:each partof question mustbe written in a separate page

 QUESTION (1) (Head)…………………………………….(22 MARKS):
A- Draw a diagram showing relations of base, apex and anterior border of the parotid gland
……………………...………………………………………………………………………………..….(6 marks)
B- Discuss origin, insertion, nerve supply and action of the masseter muscle (diagram not
needed)………………………………………………………………………………………………..(5 marks)
C- Enumerate the contents and tributaries of cavernous sinus (diagram not needed). Write a
note about the applied anatomy of dangerous area of the face…………………………….(6 marks)
D- Enumerate the branches of the ophthalmic artery………………………………..……….(5 marks)
_________________________________________________________________________________
 QUESTION (2) (Neck& Cavities)………..………………(21 MARKS):
A- Enumerate the boundaries, roof, floor and contents of digastric triangle (diagram
needed)………………………………………………………………………………………………...(5 marks)
B- Discuss origin, course and branches of the lingual artery (diagram needed)………..(4 marks)
C- Enumerate the branches of vagus nerve (diagram not needed). ……………………….(4 marks)
D- Discuss the structures in the lateral wall of the nasopharynx (diagram needed)……(5 marks)
E- Problem solving (3 marks):
A 25 years old man suffered from recurrent nasal obstruction and severe pain over the upper
jaw. On examination, the diagnosis was sinusitis (inflammation of paranasal sinuses)
1- Which was the most affected sinus…………………………………………………………….(1 mark)
a- Frontal sinus b- Maxillary sinus c- Sphenoid sinus
2- What is the site of opening of this sinus in the lateral nasal wall………………………...(1 mark)
3- Enumerate two arteries supplying this sinus…………………………………………………(1 mark)
________________________________________________________________________________
 QUESTION (3) (Neuroanatomy)………………………(22 MARKS):
A- Write a short note about the fixation of spinal cord and the spinal nerves (diagram not
needed)…………………...........................................................................................................(6 marks)
B- Discuss the functional components of the facial nerve (diagram not needed)……....(5 marks)
C- Draw a diagram showing the boundaries of the body of the lateral ventricle ……….(5 marks)
D- Enumerate commissural fibres of the cerebral hemispheres. Draw a diagram showing the
parts of corpus callosum …………………………………………………………………….…..(6 marks)
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2.  QUESTION (4) (Lower limb)…………..………………(22 MARKS):
A- Discuss the formation and compartments of femoral sheath (diagram
needed)………………………………………………………………………………………………...(4 marks)
B- Mention origin, insertion, nerve supply and action of semitendinosus muscle (diagram
needed)………………………………………………………………………………………………...(5 marks)
C- Enumerate the branches of the musculocutaneous (superficial peroneal) nerve (diagram not
needed)………………………………………………………………………………………………...(5 marks)
D- Enumerate the arteries sharing in anastomosis around the ankle joint (diagram
needed)………………...............................................................................................................(5 marks)
E- Mention the surface anatomy of the sciatic nerve (diagram not needed)……………..(3 marks)
_________________________________________________________________________________
 QUESTION (5) (Special Embryology)..……………..(13 MARKS):
A- Discuss the congenital anomalies of the urinary bladder………………………………..(5 marks)
B- Mention the embryological components of the two ventricles of the heart…………..(3 marks)
C- Discuss the development of the pancreas……………………………………………….…(5 marks)
_________________________________________________________________________________
 QUESTION (6): MCQ……………………………………(25 MARKS):
(25) Questions. Mark only the letter of chosen answer in the MCQ page of the answer paper
Oral Examination:
Monday 30/9/2013: At 8.5 o'clock oral examination
At 10 o'clock practical examination
With My Best Wishes
Chairmanof Department: Prof.Dr. Mona Zoair
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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 following layer of the scalp is the dangerous area:
A) Skin B) Connective subcutaneous tissue
C) Loose areolar tissue D) Pericranium
2- The following nerve is a branch from Ophthalmic nerve in the face:
A) Zygomaticofacial nerve B) Ifratrochlear nerve
C) Infraorbital nerve D) Buccal nerve.
3- The deep head of the medial pterygoid muscle arises from:
A) Medial surface of lateral pterygoid plate B) lateral surface of lateral pterygoid plate
C) Medial surface of medial pterygoid plate D) Lateral surface of medial pterygoid plate
4- The following artery passes upwards through the foramen spinosum:
A) Deep auricular artery B) Anterior tympanic artery
C) Accessory meningeal artery D) Middle meningeal artery
5- The pterygomandibular ligament is attached below to:
A) Angle of mandible. B) Lingula of mandible
C) Lateral surface of neck of mandible D) Posterior end of mylohyoid line
6- The following extra-ocular muscle is supplied by superior division of occulomotor nerve:
A) Superior rectus muscle B) Superior oblique muscle
C) Inferior rectus muscle D) Lateral rectus muscle
7- The following dural venous sinus occupies the upper convex margin of falx cerebri:
A) Straight sinus B) Superior petrosal sinus
C) Inferior sagittal sinus D) Superior sagittal sinus
8- The following vein is a tributary of external jugular vein :
A) Lingual vein B) Superior thyroid vein
C) Anterior jugular vein D) Common facial vein
9- Submandibular salivary gland lies in the following division of anterior triangle of the neck:
A) Digastric triangle B) Submental triangle
C) Carotid triangle D) Muscular triangle
10- Anterior superior quadrant of lateral nasal wall is supplied by the following artery:
A) Anterior ethmoidal artery B) Facial artery
C) Sphenopalatine artery D) Greater palatine artery
11- Glossopharyngeal nerve leaves the skull through the following foramen:
A) Anterior condylar canal B) Jugular foramen
C) Stylomastoid foramen D) Carotid canal
12- Lymphatics from tip of the tongue drain to:
A) Deep cervical lymph nodes B) Submandibular lymph nodes
C) Submental lymph nodes D) Superficial cervical lymph nodes
13- The medial wall of mastoid antrum is related to :
A) Tegmen tympani B) Tympanic cavity
C) Posterior semicircular canal D) Suprameatal triangle of skull
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4. 14- The Auditory centres (areas 41& 42) are present in:
1. A) Frontal lobe B) Parietal lobe
C) Occipital lobe D) Temporal lobe
15- The lateral 1/5 of the crus cerebri of the midbrain is formed by the following nerve fibres:
A) Cortico-spinal fibres
B) Fronto-pontine fibres
C) Cortico- bulbar fibres
D) Tempro- pontine, parieto- pontine& occipito- pontine fibres.
16- The inferior thalamic radiation connects:
A) Ventral nuclei with the parietal lobe B) Medial and anterior nuclei with the frontal lobe.
C) Pulvinar with the occipital lobe. D) Pulvinar with the temporal lobe.
17- The floor of posterior horn of lateral ventricle shows the following:
A) Collateral eminence B) Calceravis
C) Corpus striatum D) Hippocampus
18- The middle part of the roof of fourth ventricle is formed by:
A) Superior medullary velum B) White core of cerebellum
C) Inferior medullary velum D) Tela choroidea of 4th
ventricle
19- The following artery is not a branch of the vertebral artery:
A) Anterior spinal artery B) Posterior spinal artery
C) Medullary arteries D) Pontine arteries
20- The tensor fascia lata is supplied by the following nerve:
A) Femoral nerve B) Superior gluteal nerve
C) Inferior gluteal nerve D) Obturator nerve
21- Semimemranosus muscle arises from:
A) Upper lateral part of upper area of ischial tuberosity
B) Lower medial part of upper area of ischial tuberosity
C) Lateral part of lower area of ischial tuberosity
D) Medial part of lower area of ischial tuberosity
22- The medial boundary of femoral ring is formed by:
A) Pectineal ligament B) Lacunar ligament
C) Femoral vein D) Inguinal ligament
23- The following muscle is supplied by posterior division of obturator nerve:
A) Adductor longus B) Ischeal part of adductor magnus
C) Obturator internus D) Obturator externus
24- The action of tibialis posterior muscle is:
A) Dorsiflexion and inversion B) Planter flexion and inversion
C) Dorsilexion and eversion D) Planter flexion and eversion
25- The flexion of the hip joint is done by the following muscle:
A) Rectus femoris B) Gluteus medius
C) Tensor fascia lata D) Gluteus maximus
END OF THE EXAM
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5. MCQ QuestionsAnswer Key For
29/9/2013)-(Malaysian Anatomy Exam
1- C)
2- B)
3- A)
4- D)
5- D)
6- A)
7- D)
8- C)
9- A)
10- A)
11- B)
12- C)
13- C)
14- D)
15- D)
16- D)
17- B)
18- B)
19- D)
20- B)
21- A)
22- B)
23- D)
24- B)
25- A)
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6. ANATOMY DEPARTMENT:
MODEL ANSWER OF SECOND YEAR
FINAL ANATOMY EXAMINATION (Malaysians) 29/9/2013

 QUESTION (1) (HEAD)………(22 MARKS):
1- A- A diagram showing the relations of base, apex and anterior border of the
parotid gland (6 marks)
_________________________________________________________________________________
1- B- Origin,insertion,nervesupply and action of the masseter muscle (diagram
not needed) (5 marks)
 Origin:
The muscle arises by 2 heads.
 Superficial head : Arises from the lower border of the zygomatic arch.
 Deep head: Arises from the deep surface of the zygomatic arch.
 Insertion:
Into the lateral surface of the ramus of mandible.
 Nerve supply:
By the masseteric branch of the anterior division of the mandibular nerve.
 Action:
- Close the jaws by elevating the mandible.
- Superficial fibers protrude the mandible
- Deep fibers retract the protruded mandibl
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7. 1- C- The contents and tributaries of cavernoussinus (diagram not needed). And
a note about the applied anatomy of dangerous area of the face (6 marks)
Contents
 Internal carotid artery surrounded by sympathetic nerve plexus and runs forwards in its cavity.
 The abducent nerve (6th cr) lies lateral & below the artery
Tributaries
 Superficial middle cerebral vein.
 Central vein of retina
 Superior and inferior ophthalmic veins.
 Sphenoparietal sinus.
 Meningeal veins.
pplied anatomy of dangerous area of the faceA
- It is an area of facial skin bounded by the nose, eye, and upper lip.
- Infection from this area may spread through the superior ophthalmic vein to the cavernous sinus
causing cavernous sinus thrombosis.
_________________________________________________________________________________
1- D- The branches of the ophthalmic artery (5 marks)
- Central artery of the retina
- Lacrimal artery
- Supraorbital artery
- Ciliary arteries; Long posterior ciliary, short posterior ciliary and anterior ciliary
- Ethmoidal arteries ; anterior and posterior
- Meningeal branch
- Muscular branches:
- Medial palpebral arteries
- Supratrochlear artery
- Dorsal nasal artery
2

8. 
 QUESTION (2) (Neck& Cavities)………..………………(21 MARKS):
2- A-The boundaries, roof, floor and contents of digastric triangle (diagram
needed)(5 marks)
 Boundaries:
Above : body of the mandible.
Below & anteriorly: anterior belly of digastric.
 Below & posteriorly : posterior belly of digastric& stylohyoid
 Floor:
Anteriorly : mylohyoid muscle
Posteriorly : part of hyoglossus muscle.
 Roof:
Skin & superficial fascia
Platysma & deep fascia.
 Contents:
Submandibular salivary gland
Submandibular lymph nodes
Anterior facial vein
Facial artery
Lingual nerve and submandibular ganglion
Hypoglossal nerve
 Mylohyoid nerve.
_________________________________________________________________________________
2- B- Origin,courseand branchesof the lingualartery (diagram needed)(4 marks)
 Arises from the external carotid artery opposite the tip of greater cornu of hyoid bone.
 It runs forwards :
- Above the hyoid bone
- Deep to the hyoglossus muscle.
 It then passes upwards along the anterior border of the hyoglossus to the tip of the tongue. This
part of the artery is called the deep lingual or profunda artery.
Branches:
 Suprahyoid artery:
- Runs along the upper border of hyoid bone.
 Dorsal lingual branches:
- Ascend to the dorsum of the tongue.
 Sublingual artery:
Ascends upwards and forwards on the genioglossus deep to mylohyoid to supply the sublingual
gland
3

9. 2- The branches of vagus nerve (diagram not needed).(4 marks)
1- Communicating branches :
- To 9th ,11th & 12th cranial nerves
- Superior cervical sympathetic ganglion.
- 1st cervical nerve
2- 2 branches arise from the superior ganglion:
 Meningeal branch
 Auricular branch
3- 2 branches arise from the inferior ganglion:
 Pharyngeal branch
 Superior laryngeal branch divides into:
* Internal laryngeal nerve supplies the mucous membrane of the upper part of larynx down to the
level of vocal folds.
* External laryngeal nerve supplies the cricothyroid muscle.
4- Cardiac branches:
Superior and inferior cardiac branches which arise in the neck and join the cardiac plexuses in the
thorax
5- Recurrent laryngeal nerves which gives sensory supply to the mucous membrane of larynx below
the vocal folds , motor all the muscles of larynx except the cricothyroid and parasympathetic and
cardiac branches which join the cardiac plexuses.
_________________________________________________________________________________
2- D- The structures in the lateral wall of the nasopharynx (diagram needed)
(5 marks)
It shows the following features:
1-Auditory tube opening.
2-Tubal elevation; it is the elevation formed by the upper and posterior margins of the opening of
the auditory tube.
3-Pharyngeal recess ; is a depression in the pharyngeal wall behind the tubal elevation
4-Salpingopharyngeal fold :
* It is a vertical fold of mucous membrane which runs downwards from the tubal elevation to the
side wall of the pharynx.
* It contains the salpingopharyngeus muscle
5-Tubal tonsils ; are collections of lymphoid tissue near the tubal opening
_________________________________________________________________________________
2- E- Problem solving (3 marks):
1- a-The most affected sinus is maxillary sinus (1 mark)
2- The site of opening of maxillary sinus is into hiatus semilunaris below bulla ethmoidalis in the
middle nasal meatus (1 mark)
3- Two arteries supplying this sinus are posterior superior alveolar artery and anterior superior
alveolar artery (1 mark)
4

10.  QUESTION(3) (Neuroanatomy)………………………(22MARKS):
3-A- A short note about the fixation of spinal cord and the spinal nerves
(diagram not needed).(6 marks)
Fixation:
1-The spinal cord is supported and fixed by:
. 2-Denticulate ligament.
. 3-Filum terminale.
4- Spinal nerve roots, which provide the strongest fixation of the cord to the vertebral canal.
. Fixation of its dura to the foramen magnum.
Spinal nerves:
- They are 31 pairs emerge from the corresponding spinal cord segments.
- They are 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and only one coccygeal.
- Each spinal nerve is attached to the spinal cord by smaller, efferent anterior root and larger,
afferent posterior root. Its fibres are the central processes of the dorsal root ganglion.
- The anterior and posterior roots join in the intervertebral foramen to form the spinal nerve trunk,
which soon divides into dorsal and ventral rami.
_________________________________________________________________________________
3- B- The functional components of the facial nerve (diagram not needed)
(5 marks)
1. Motor supply to the muscles derived from the mesoderm of the second branchial arch by special
visceral efferents (SVE). These muscles are stapedius, muscles of the face, stylohyoid, posterior
belly of digastric, posterior auricular and platysma.
2. Parasympathetic secretomotor supply to the lacrimal gland and salivary glands (sublingual &
submandibular) by GVE.
3. The sensory fibers coming from the skin of the external ear are GSA. They pass towards the brain
stem to reach the spinal nucleus of the trigeminal.
4. The taste sensory fibres coming from the anterior 2/3 of the tongue pass into the lingual (branch of
mandibular) then to chorda tympani (branch of facial) the facial and then enter the pons through the
sensory root. Lastly, it ends in the large lateral part of nucleus solitarius. These taste fibres are
functionally SVA.
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11. 3- C- A diagram showing the boundaries of the body of the lateral ventricle
(5 marks)
________________________________________________________________________________
3-D- Commissuralfibres of the cerebralhemispheres and a short note about the
genu of corpus callosum (diagram not needed)(5 marks)
Commissural fibres of the cerebral hemispheres
1. Corpus Callosum
2. Anterior Commissure
3. Posterior Commissure
4. Habenular Commissure
5. Commissure of Fornix
A diagram showing parts of corpus callosum
6

12.  QUESTION (4) (Lower limb)…………..………………(22 MARKS):
4- A- The formation and compartments of femoral sheath (diagram needed).
(4 marks)
 Formation:
- Anterior wall is a downward prolongation of fascia transversalis lining the anterior abdominal wall.
- Posterior wall is a downward prolongation of fascia iliaca lining the posterior abdominal wall.
- Inferiorly the sheath merges with the perivascular sheath of femoral vessels.
 Compartments:
2 antero-posterior septa divide the sheath into 3 compartments.
- Lateral compartment: Containing the femoral artery and femoral branch of genitofemoral nerve.
- Intermediate compartment: Containing femoral vein.
- Medial compartment: called the femoral canal.
_________________________________________________________________________________
4- B- Origin, insertion, nerve supply and action of semitendinosus muscle
(diagram not needed) (5 marks)

 Origin:
It arises from the lower medial part of the upper quadrangular area of ischial tuberosity with the long
head of biceps.
 Insertion:
It is inserted into the upper part of medial surface of tibia below and behind the insertion of sartorius
and gracilis .

 Nerve supply:
Sciatic nerve (through its tibial branch) ( L4,5,S1,2)

 Action:
- Extension of the hip joint.
- Flexion & medial rotation of knee joint.
- It is one of the (guy ropes) which steady the pelvis on femur.
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13. 4- C- The branches of the musculocutaneous (Superficial peroneal) nerve
(diagram not needed). (5 marks)
 Muscular branches: Supply the peroneus longus & brevis muscles.
 Cutaneous branches:
* To the lower 2/3 of antero-lateral aspect of the leg.
* The terminal branches supply the intermediate part of the dorsum of foot.
* The medial terminal branches:
Divides into 2 dorsal digital branches:
- One for the medial side of big toe.
- One for the adjacent sides of the 2nd & 3rd toes.
* The lateral terminal branch:
Divides into 2 dorsal digital branches:
- One for the adjacent sides of 3rd and 4th toes.
- One for the adjacent sides of 4th and 5th toes.
_____________________________________________________________________
4- D- The arteries sharing in anastomosis around the ankle joint (diagram
needed) (5 marks)
 Anastomosis around the lateral malleolus:
 Antero-lateral malleolar branch of anterior tibial artery.
 Lateral tarsal branch of dorsalis pedis artery.
 Twigs from lateral plantar artery
 Lateral calcanean branch of peroneal artery.
 Perforating branch of peroneal artery
 Anastomosis around the medial malleolus:
 Antero-medial malleolar branch of anterior tibial artery.
 Medial tarsal branch of dorsalis pedis artery.
 Twigs from medial plantar artery.
 Medial calcanean branch of posterior tibial artery.
 Postero-medial malleolar branch of posterior tibial artery
_____________________________________________________________________
4- E- The surface anatomy of the sciatic nerve (diagram not needed) (3 marks)
Surface anatomy:
- It can be represented by a line joining the following 3 points:
1st: A point 1 inch lateral to the midpoint between the posterior superior iliac spine and ischial
tuberosity.
2nd: A point just medial to the midpoint between ischial tuberosity and greater trochanter.
3rd: A point on the middle line on the back of the thigh at the junction between its upper 2/3 and the
lower 1/3
8

14. 
 QUESTION (5) (Special Embryology)..……………..(13 MARKS):
5-A - The congenitalanomaliesof the urinary bladder(5 marks)
1) Urachal fistula:
- The allantois fails to become obliterated and the urine passes out of the patent urachus to the
umbilicus.
2) Urachal cyst:
- Occurs when a localized area of the allantois persists.
- The secretory activity of the lining epithelium results in a cystic dilatation.
3) Urachal sinus:
-The proximal part of the urachus is obliterated and fibrosed, while its distal part remains patent.
- This leads to the formation of a sinus with discharge of serous fluid through the umbilicus.
4) Ectopia vesica:
- Occurs when the posterior wall of the urinary bladder is exposed to the exterior.
- It is caused by the failure of the anterior abdominal wall and anterior wall of the bladder to develop.
- This defect is due to inability of the mesoderm of the primitive streak to migrate around the cloacal
membrane.
_______________________________________________________________________________
5- B- The embryologicalcomponents of the two ventricles(3marks)
Right ventricle develops from:
1. Right part of the primitive ventricle forms the rough trabeculated part.
2. Infundibulum from the right part of the bulbus cordis forms the smooth part.
Left ventricle develops from:
1. Left part of the primitive ventricle forms the rough trabeculated part.
2. Vestibule from the left part of the bulbus cordis forms the smooth part.
_____________________________________________________________________
5- C- The development of the pancreas (5 marks)
 It develops from ventral and dorsal buds originating from endodermal lining of duodenum.
 Dorsal bud is located short distance above ventral bud.
 Ventral bud arises in common with hepatic bud close to junction of foregut with midgut.
 As the duodenum rotates to right and becomes C- shaped the ventral pancreatic bud migrates
dorsally.
 It lies immediately below and behind dorsal pancreatic bud.
 Then, parenchyma and duct system of ventral and dorsal buds fuse together.
 Ventral bud forms uncinate process and inferior part of head of pancreas.
 Dorsal bud forms the remaining part of pancreas.
 The main pancreatic duct is formed by distal part of dorsal pancreatic duct and the whole ventral
pancreatic duct. It enters duodenum at major papilla.
 Proximal part of dorsal pancreatic duct is obliterated or persists as accessory pancreatic duct
which enters duodenum at site of minor papilla.
9