Answer all mcq
Reading File
Running Command
cd /tmp/workspace/attachments/62046d32-4f59-4aae-af68-3a8b4c7f94e5/ && python3 -c " import pdfplumber with pdfplumber.open('mcq expected.pdf') as pdf: print(f'Pages: {len(pdf.pages)}') for i, page in enumerate(pdf.pages): text = page.extract_text() print(f'--- PAGE {i+1} ---') print(text) print() "
Running Command
cd /tmp/workspace/attachments/62046d32-4f59-4aae-af68-3a8b4c7f94e5/ && python3 -c " from pypdf import PdfReader import base64, json reader = PdfReader('mcq expected.pdf') print(f'Pages: {len(reader.pages)}') # Try to extract images from each page for i, page in enumerate(reader.pages): print(f'Page {i+1} resources: {list(page.get(\"/Resources\", {}).keys()) if page.get(\"/Resources\") else \"none\"}') images = page.images print(f' Images on page {i+1}: {len(images)}') for j, img in enumerate(images[:2]): print(f' Image {j}: name={img.name}, size={len(img.data)} bytes') "
Running Command
python3 -c " from pypdf import PdfReader import os reader = PdfReader('/tmp/workspace/attachments/62046d32-4f59-4aae-af68-3a8b4c7f94e5/mcq expected.pdf') os.makedirs('/tmp/workspace/mcq_images', exist_ok=True) for i, page in enumerate(reader.pages): images = page.images for j, img in enumerate(images): ext = img.name.split('.')[-1] out_path = f'/tmp/workspace/mcq_images/page{i+1}_{j}.{ext}' with open(out_path, 'wb') as f: f.write(img.data) print(f'Saved: {out_path}') "
Reading File
Reading File
Reading File
Running Command
python3 -c " from PIL import Image import os # Convert jp2 to jpg for easier reading img = Image.open('/tmp/workspace/mcq_images/page4_0.jp2') img.save('/tmp/workspace/mcq_images/page4_0.jpg') print('Converted jp2 to jpg') print(f'Size: {img.size}') "
Running Command
python3 -c " from PIL import Image img = Image.open('/tmp/workspace/mcq_images/page4_0.jp2') img = img.convert('RGB') img.save('/tmp/workspace/mcq_images/page4_0.jpg') print('Done, size:', img.size) "
Reading File
Now I have all 4 pages. Let me answer all 40 MCQs (20 from Anatomy 1st + 20 from Anatomy 2nd).
RUHS MBBS Predicted Question Paper 2026 - Anatomy MCQ Answers
Anatomy 1st (Questions 1-20)
Q1. A 25-year-old man falls from a motorcycle landing on right shoulder - arm hangs adducted, medially rotated, forearm extended and pronated. Which brachial plexus roots are injured?
Answer: A. C5, C6
This is the classic "Waiter's tip" (Erb-Duchenne) palsy. The arm position described (arm adducted, medially rotated, forearm extended and pronated) results from injury to the upper trunk of the brachial plexus - roots C5 and C6. Landing heavily on the shoulder forces the head and shoulder apart, stretching these upper roots.
Q2. A 40-year-old typist has pain and tingling in the thumb, index, and middle fingers, worsening at night, with weakness of thenar muscles. Which nerve?
Answer: C. Median nerve
This is classic Carpal Tunnel Syndrome. The median nerve supplies sensation to the thumb, index, middle, and radial half of the ring finger, and innervates the thenar muscles (LOAF: Lateral two lumbricals, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis). Night worsening is characteristic.
Q3. A 30-year-old man has a midshaft humerus fracture and is unable to extend his wrist and fingers. Which nerve is compromised?
Answer: B. Radial nerve
The radial nerve winds around the posterior aspect of the midshaft of the humerus in the spiral (radial) groove. A midshaft fracture damages it, causing wrist drop (inability to extend wrist and fingers).
Q4. Which of the following structures pierces the clavipectoral fascia?
Answer: A. Cephalic vein
The clavipectoral fascia is pierced by the cephalic vein (draining into the axillary vein), the lateral pectoral nerve, and the thoracoacromial artery. The cephalic vein is the classic answer for piercing this fascia.
Q5. Boil on tip of nose → high fever, exophthalmos, paralysis of extraocular muscles. Infection spread to cavernous sinus via which route?
Answer: A. Superior ophthalmic vein
The tip of the nose drains via the angular vein → facial vein → superior ophthalmic vein → cavernous sinus. The "danger area of the face" (nose, upper lip) drains this way. The superior ophthalmic vein has no valves, allowing retrograde spread of infection into the cavernous sinus.
Q6. Pancoast tumor at lung apex → partial ptosis, miosis, anhidrosis (Horner's syndrome). Partial ptosis is due to paralysis of which muscle?
Answer: B. Superior tarsal muscle (Müller's muscle)
In Horner's syndrome, the sympathetic chain is interrupted. Müller's muscle (superior tarsal muscle) is a smooth muscle innervated by sympathetic fibers that contributes about 2 mm of upper eyelid elevation. Its paralysis causes the partial (1-2 mm) ptosis seen in Horner's syndrome - distinguishable from the complete ptosis of CN III palsy, which is caused by paralysis of the levator palpebrae superioris.
Q7. During subtotal thyroidectomy - ligation of inferior thyroid artery - which nerve is at greatest risk of causing hoarseness?
Answer: C. Recurrent laryngeal nerve
The recurrent laryngeal nerve (RLN) is intimately related to the inferior thyroid artery as it enters the larynx. It is the nerve most commonly injured during thyroid surgery. RLN injury causes hoarseness because it innervates all intrinsic laryngeal muscles except cricothyroid.
Q8. Squamous cell carcinoma at the tip of the tongue - which lymph nodes receive metastases first?
Answer: D. Jugulo-omohyoid nodes (also called submental nodes → then deep cervical)
The tip of the tongue drains bilaterally to the submental nodes first, then to the jugulo-omohyoid nodes. Among the options, D. Jugulo-omohyoid nodes are a key station for tongue tip drainage. However, strictly, the very first nodes for the tongue tip are submental nodes (option A). Given the options and clinical context, A. Submandibular nodes is the intended correct answer for drainage from the tongue tip - the submental nodes first, then submandibular.
Answer: A. Submandibular nodes (tip of tongue drains to submental → submandibular nodes as initial lymphatic drainage)
Q9. Lateral Medullary (Wallenberg) Syndrome - occlusion of which artery?
Answer: B. Posterior inferior cerebellar artery (PICA)
Wallenberg syndrome (lateral medullary syndrome) is classically caused by occlusion of PICA or the vertebral artery. It presents with ipsilateral facial pain/temperature loss, contralateral body pain/temperature loss, ipsilateral Horner's, dysphagia, hoarseness, vertigo, and cerebellar ataxia - matching the clinical description.
Q10. Hemorrhage in the posterior limb of the left internal capsule. Ruptured artery (Charcot's artery of cerebral hemorrhage) is a branch of which vessel?
Answer: B. Middle cerebral artery
Charcot's artery (the lenticulostriate arteries) are branches of the middle cerebral artery (MCA). They supply the internal capsule and basal ganglia, and are the most common site of hypertensive cerebral hemorrhage. They arise from the M1 segment of the MCA.
Q11. CSF flows from the third ventricle to the fourth ventricle through which structure?
Answer: B. Cerebral aqueduct (of Sylvius)
The cerebral aqueduct (aqueduct of Sylvius) connects the third and fourth ventricles. The interventricular foramen (of Monro) connects the lateral ventricles to the third ventricle. Foramina of Magendie and Luschka are outlets of the fourth ventricle.
Q12. Fracture of lower end of femur in a 10-year-old - which part must be damaged to stop longitudinal growth?
Answer: C. Epiphyseal plate
The epiphyseal plate (growth plate / physis) is responsible for longitudinal bone growth. Damage to it (Salter-Harris fractures) can cause growth arrest. The distal femoral epiphyseal plate is one of the most growth-productive plates in the body.
Q13. After radical mastectomy with axillary lymph node dissection - unable to raise arm above 90°, medial border of scapula becomes prominent when pushing against wall. Which nerve was injured?
Answer: C. Long thoracic nerve
The long thoracic nerve (nerve of Bell) innervates the serratus anterior muscle. Injury causes "winging of the scapula" - the medial border becomes prominent, especially when pushing against a wall. Inability to raise the arm above 90° also results from serratus anterior paralysis (which is needed to rotate the scapula for full arm elevation).
Q14. Which of the following is NOT a branch of the axillary artery?
Answer: C. Suprascapular artery
The branches of the axillary artery (3 parts, 1-2-3 branches): Superior thoracic (1st part); Thoracoacromial, Lateral thoracic (2nd part); Subscapular, Anterior and Posterior circumflex humeral arteries (3rd part). The suprascapular artery is a branch of the thyrocervical trunk (from subclavian artery), NOT the axillary artery.
Q15. Bell's palsy - nerve compressed at which foramen?
Answer: C. Stylomastoid foramen
The facial nerve (CN VII) exits the skull through the stylomastoid foramen. Bell's palsy is idiopathic inflammation of the facial nerve, most commonly at this level or within the facial canal. Compression here produces lower motor neuron facial palsy - inability to close eye, drooping mouth corner, drooling.
Q16. Which muscle is the "safety muscle of the tongue" - its paralysis causes tongue to fall back and obstruct the airway?
Answer: A. Hyoglossus
No - the correct answer is C. Genioglossus. The genioglossus is the main protruder of the tongue. It is called the "safety muscle of the tongue" because its bilateral paralysis (as in unconscious patients) causes the tongue to fall posteriorly and obstruct the airway. This is why jaw-thrust maneuver and airway positioning are essential in unconscious patients.
Answer: C. Genioglossus
Q17. Broca's aphasia - lesion in motor speech area - supplied primarily by which artery?
Answer: B. Middle cerebral artery
Broca's area (inferior frontal gyrus, pars triangularis and opercularis) is supplied by the middle cerebral artery (specifically the superior division of the MCA). MCA strokes are the most common cause of Broca's aphasia.
Q18. First carpometacarpal joint (thumb) - allows wide range including opposition - which type of synovial joint?
Answer: C. Saddle joint
The first carpometacarpal (CMC) joint of the thumb is a classic example of a saddle joint (sellar joint). Its reciprocally concavo-convex surfaces allow flexion/extension, abduction/adduction, and circumduction, enabling opposition - the most important thumb movement.
Q19. Fundamental ethical concept regarding the cadaver in medical education (AETCOM module)?
Answer: B. The cadaver should be treated as the medical student's first teacher with utmost respect
The AETCOM (Attitudes, Ethics and Communication) module in Indian medical education emphasizes that the cadaver is the "first teacher" of medical students and must be treated with dignity and utmost respect. This is the foundational ethical principle.
Q20. Which of the following passes through the foramen ovale?
Answer: C. Mandibular nerve
The foramen ovale transmits the mandibular nerve (V3), the motor root of the trigeminal nerve, the accessory meningeal artery, the lesser petrosal nerve (sometimes), and the emissary vein. The maxillary nerve passes through foramen rotundum; the middle meningeal artery passes through foramen spinosum; the internal carotid artery passes through the carotid canal.
Anatomy 2nd (Questions 1-20)
Q1. Fibula neck fracture - high-stepping gait, unable to dorsiflex right foot. Which nerve is damaged?
Answer: B. Common peroneal (fibular) nerve
The common peroneal nerve winds around the neck of the fibula and is vulnerable to injury here. It supplies the muscles of dorsiflexion and eversion. Damage causes foot drop (inability to dorsiflex) and high-stepping gait. Deep peroneal branch specifically causes foot drop but the common peroneal nerve at the neck is the classic answer.
Q2. Poorly placed gluteal injection - positive Trendelenburg sign (opposite side of pelvis drops). Which nerve was injured?
Answer: B. Superior gluteal nerve
The superior gluteal nerve innervates gluteus medius, gluteus minimus, and tensor fasciae latae - the hip abductors. These muscles keep the pelvis level when standing on one leg. Injury causes Trendelenburg sign (pelvis drops on the contralateral side when standing on the injected leg). The safe zone for gluteal injections is the upper outer quadrant to avoid this nerve.
Q3. Harvesting great saphenous vein for CABG - incision location in lower leg?
Answer: D. Anterior to the medial malleolus
The great saphenous vein passes anterior to the medial malleolus at the ankle. This is the most reliable surgical landmark for the vein. (It runs along the medial aspect of the leg, originating from the dorsal venous arch of the foot, passing in front of the medial malleolus.)
Q4. Which muscle is responsible for "unlocking" the knee joint by laterally rotating the femur on the tibia before flexion?
Answer: B. Popliteus
The popliteus muscle "unlocks" the knee. The fully extended knee is "locked" in a screw-home mechanism (tibia laterally rotated on femur). Popliteus medially rotates the tibia on the femur (or laterally rotates the femur on the fixed tibia) to unlock the joint, allowing flexion to begin.
Q5. Inhaled peanut in a 4-year-old - most likely lodged in right principal bronchus because it is:
Answer: B. Wider, shorter, and more vertical than the left
The right main bronchus is wider, shorter, and more vertical than the left - it is a more direct continuation of the trachea. Therefore, inhaled foreign bodies preferentially enter the right main bronchus (and typically lodge in the right lower lobe).
Q6. Massive MI - complete occlusion of artery supplying anterior two-thirds of interventricular septum and anterior wall of left ventricle. Which artery?
Answer: C. Anterior interventricular artery (LAD)
The Left Anterior Descending (LAD) artery (anterior interventricular branch of the left coronary artery) supplies the anterior interventricular septum and anterior wall of the left ventricle. It is called the "widow maker" because its occlusion causes massive anterior MI.
Q7. Which represents a typical intercostal nerve?
Answer: C. 4th intercostal nerve (or B. 2nd intercostal nerve - but 3rd-6th are most "typical")
A typical intercostal nerve runs entirely in the intercostal space without special communications. The 1st and 2nd have atypical features (1st contributes to the brachial plexus; 2nd gives the intercostobrachial nerve). The 7th-11th are also atypical (costoabdominal nerves). The 3rd, 4th, 5th, and 6th intercostal nerves are the typical ones.
Answer: C. 4th intercostal nerve
Q8. Periumbilical pain of appendicitis is referred pain mediated by which spinal cord segment?
Answer: B. T10
Appendicitis initially causes visceral pain, which is referred to the umbilicus. The appendix receives its visceral sensory supply via sympathetic fibers running with the lesser splanchnic nerve, entering the spinal cord at T10. This explains the early periumbilical pain before it localizes to the right iliac fossa (McBurney's point).
Q9. Carcinoma of the head of the pancreas causes painless obstructive jaundice primarily due to compression of:
Answer: B. Bile duct (Common bile duct)
The common bile duct (CBD) passes through the head of the pancreas (in a groove or tunnel). A carcinoma of the pancreatic head compresses the CBD, causing painless progressive obstructive jaundice - this is the classic presentation. Courvoisier's sign (palpable, non-tender gallbladder) results from this obstruction.
Q10. Caput medusae in portal hypertension is caused by reopening of portocaval anastomosis between superficial epigastric veins and:
Answer: C. Paraumbilical veins
Caput medusae results from reversal of flow through the paraumbilical veins (in the falciform ligament), which connect the portal vein to the superficial epigastric veins of the anterior abdominal wall. Portal hypertension forces blood through this portocaval anastomosis, distending the periumbilical veins to form the classic caput medusae appearance.
Q11. The epiploic foramen (Foramen of Winslow) - what forms its anterior boundary?
Answer: D. Free margin of the lesser omentum
The boundaries of the epiploic foramen (foramen of Winslow):
- Anterior: Free margin of the lesser omentum (containing portal triad: portal vein, hepatic artery, bile duct)
- Posterior: Inferior vena cava
- Superior: Caudate lobe of the liver
- Inferior: First part of the duodenum
Q12. Ruptured ectopic pregnancy - blood accumulates in most dependent part of pelvic cavity in supine position. Where?
Answer: B. Rectouterine pouch (Pouch of Douglas)
The rectouterine pouch (pouch of Douglas) is the most dependent part of the pelvic cavity in both males and females in the supine position. It is located between the rectum and the uterus/posterior vaginal fornix. Blood from a ruptured ectopic pregnancy will pool here first.
Q13. Prostate cancer metastases to lumbar vertebrae via:
Answer: C. Internal vertebral venous plexus (Batson's plexus)
Batson's plexus (the internal vertebral venous plexus) is a valveless venous plexus that communicates with the prostatic venous plexus. The absence of valves allows retrograde flow, enabling cancer cells to spread directly to the vertebral column. This explains the frequent vertebral metastases in prostate, breast, lung, kidney, and thyroid cancers.
Q14. During total abdominal hysterectomy - ligation of uterine artery near lateral fornix - which vital structure is at risk?
Answer: D. Ureter
The ureter crosses under the uterine artery ("water under the bridge") approximately 1-2 cm lateral to the cervix at the level of the lateral fornix. During hysterectomy, the ureter is at high risk of being accidentally clamped or ligated when the surgeon ties the uterine artery. This is a well-known surgical complication.
Q15. Cyanotic congenital heart disease with VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy (Tetralogy of Fallot) - embryological basis?
Answer: B. Unequal division of the truncus arteriosus by the aorticopulmonary septum
Tetralogy of Fallot results from unequal partitioning of the truncus arteriosus by the aorticopulmonary septum. The septum divides the truncus unequally and anteriorly, resulting in a large aorta, small pulmonary trunk (pulmonary stenosis), VSD (from mal-alignment), and consequent right ventricular hypertrophy. The aorta overrides the VSD.
Q16. After birth, the left umbilical vein obliterates and forms a fibrous cord in the free margin of the falciform ligament. What is this remnant called?
Answer: C. Ligamentum teres hepatis (Round ligament of liver)
The left umbilical vein, which carries oxygenated blood from the placenta to the fetus, obliterates after birth to become the ligamentum teres hepatis (round ligament of the liver). It runs in the free margin of the falciform ligament. The ductus venosus becomes the ligamentum venosum.
Q17. 16-year-old girl with short stature, primary amenorrhea, webbed neck, 45,X0 karyotype. Diagnosis?
Answer: B. Turner syndrome
Turner syndrome (45,X0 / monosomy X) presents with short stature, primary amenorrhea (streak gonads), webbed neck, low posterior hairline, wide carrying angle (cubitus valgus), shield chest, coarctation of the aorta, and horseshoe kidney. The 45,X0 karyotype is diagnostic.
Q18. Histological slide of urinary bladder mucosa. Which type of epithelium lines this organ?
Answer: C. Transitional epithelium (Urothelium)
The urinary bladder is lined by transitional epithelium (urothelium). This specialized stratified epithelium is unique to the urinary tract - it can stretch as the bladder fills and recoil when it empties. It changes from cuboidal/columnar (empty bladder) to squamous (full bladder).
Q19. Acute cholecystitis - referred pain to right shoulder mediated by which nerve?
Answer: D. Phrenic nerve
The gallbladder and biliary tree are innervated by visceral afferents that travel with the phrenic nerve (C3, C4, C5). Inflammation of the gallbladder irritates the diaphragm, and pain is referred to the right shoulder via the phrenic nerve (C3-C5 dermatomes = right shoulder/neck region). This is the classic referred pain in cholecystitis.
Q20. Primary blood supply to embryonic hindgut derivatives (descending colon and sigmoid colon)?
Answer: C. Inferior mesenteric artery
The hindgut derivatives (descending colon, sigmoid colon, rectum, upper anal canal) are supplied by the inferior mesenteric artery (IMA). The foregut is supplied by the celiac trunk, and the midgut (small intestine to transverse colon) is supplied by the superior mesenteric artery.
Summary Answer Key
Anatomy 1st
| Q | Answer |
|---|---|
| 1 | A. C5, C6 |
| 2 | C. Median nerve |
| 3 | B. Radial nerve |
| 4 | A. Cephalic vein |
| 5 | A. Superior ophthalmic vein |
| 6 | B. Superior tarsal muscle (Müller's muscle) |
| 7 | C. Recurrent laryngeal nerve |
| 8 | A. Submandibular nodes |
| 9 | B. Posterior inferior cerebellar artery (PICA) |
| 10 | B. Middle cerebral artery |
| 11 | B. Cerebral aqueduct (of Sylvius) |
| 12 | C. Epiphyseal plate |
| 13 | C. Long thoracic nerve |
| 14 | C. Suprascapular artery |
| 15 | C. Stylomastoid foramen |
| 16 | C. Genioglossus |
| 17 | B. Middle cerebral artery |
| 18 | C. Saddle joint |
| 19 | B. The cadaver should be treated as the medical student's first teacher with utmost respect |
| 20 | C. Mandibular nerve |
Anatomy 2nd
| Q | Answer |
|---|---|
| 1 | B. Common peroneal (fibular) nerve |
| 2 | B. Superior gluteal nerve |
| 3 | D. Anterior to the medial malleolus |
| 4 | B. Popliteus |
| 5 | B. Wider, shorter, and more vertical than the left |
| 6 | C. Anterior interventricular artery (LAD) |
| 7 | C. 4th intercostal nerve |
| 8 | B. T10 |
| 9 | B. Bile duct (Common bile duct) |
| 10 | C. Paraumbilical veins |
| 11 | D. Free margin of the lesser omentum |
| 12 | B. Rectouterine pouch (Pouch of Douglas) |
| 13 | C. Internal vertebral venous plexus (Batson's plexus) |
| 14 | D. Ureter |
| 15 | B. Unequal division of the truncus arteriosus |
| 16 | C. Ligamentum teres hepatis (Round ligament of liver) |
| 17 | B. Turner syndrome |
| 18 | C. Transitional epithelium (Urothelium) |
| 19 | D. Phrenic nerve |
| 20 | C. Inferior mesenteric artery |
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