TestAS · Medicine
The structure of the body: bones, muscles, nerves and organs, with the anatomical language the texts use.
testas.de lists this topic for the Medicine module. In the test it comes as testlets: a short text, table or formula, then 4 to 8 questions you answer from it.
Topic list: testas.de
Full exam-length testlets from the Kollego course, generated the same way as our mocks. Answer from the material, then open each answer to check.
Describing positions and movements of the body
To describe the body without confusion, anatomy uses a fixed reference posture, the anatomical position: the body stands upright, faces forwards, the arms hang at the sides and the palms face forwards. All terms of position refer to this posture, whatever position the patient is actually in. A structure nearer the midline of the body is medial; one further from it is lateral. In the anatomical position, the thumb is therefore lateral to the little finger, and in the forearm the radius, on the thumb side, is lateral to the ulna.
Further pairs of terms describe position along other axes. Superior means above, inferior below. Anterior (or ventral) means towards the front, posterior (or dorsal) towards the back. Superficial structures lie nearer the surface, deep ones further inside. In the limbs, proximal means nearer the point where the limb attaches to the trunk and distal means further from it: the elbow is proximal to the wrist, and the knee is distal to the hip.
Three planes divide the body. A sagittal plane runs from front to back and divides the body into a left and a right part; the plane exactly through the midline is the median plane. A frontal (coronal) plane divides it into a front and a back part. A transverse plane divides it into an upper and a lower part; computed tomography usually shows such transverse slices.
Movements also come in pairs. Flexion bends a joint and usually reduces the angle between two parts; extension straightens it. Abduction moves a part away from the midline of the body, adduction towards it. For the fingers, the reference line is the middle finger: spreading the fingers is abduction, closing them is adduction. In the forearm, rotation that turns the palm backwards (or downwards when the elbow is bent) is pronation; during pronation the radius crosses over the ulna. Turning the palm forwards or upwards again is supination. At the ankle, lifting the foot so that the toes point upwards is dorsiflexion, and pointing the toes downwards, as when standing on tiptoe, is plantar flexion. Turning the sole of the foot inwards is inversion, turning it outwards eversion; most sprained ankles happen when the foot is forced into inversion. Using these terms, a doctor can describe a finding precisely in writing, for example "a 2 cm wound on the anterior surface of the left forearm, 5 cm proximal to the wrist".
1. A patient lies on his front with his palms facing the floor. Which statement uses the anatomical terms correctly?
D: His thumbs are lateral to his little fingers
All terms refer to the anatomical position, whatever the patient's actual posture. In the anatomical position the thumb is lateral to the little finger, so it is described as lateral.
2. A dancer stands on tiptoe. Which movement is taking place at the ankle?
C: Plantar flexion
The text says pointing the toes downwards, "as when standing on tiptoe, is plantar flexion".
3. While writing, you turn your forearm so that your palm faces the desk. What is this movement called, and what does the radius do?
C: Pronation; the radius crosses over the ulna
With the elbow bent, turning the palm downwards is pronation, and the text says that during pronation the radius crosses over the ulna.
4. A footballer twists his ankle so that the sole of his foot is forced to face inwards. Which movement caused the injury?
A: Inversion
Turning the sole of the foot inwards is inversion, and the text says most sprained ankles happen when the foot is forced into inversion.
5. Which description of the elbow is correct?
B: It is distal to the shoulder and proximal to the wrist
In the limbs, proximal means nearer the trunk and distal further from it. The elbow lies further from the trunk than the shoulder (distal) and nearer than the wrist (proximal).
6. A scan divides the body into a front and a back part. Which plane is this?
D: A frontal (coronal) plane
The text says a frontal (coronal) plane divides the body into a front and a back part. A sagittal plane gives left and right parts, a transverse plane upper and lower parts.
7. A patient spreads all fingers of one hand apart. In which finger is no abduction possible in this sense, and why?
C: The middle finger, because it is the reference line
The text says for the fingers the reference line is the middle finger: spreading the fingers away from it is abduction. The middle finger is the reference itself.
The knee: ligaments, menisci and typical injuries
The knee joint connects the thigh bone (femur) with the shin bone (tibia); the kneecap (patella) glides in a groove at the front of the femur. Because the bony surfaces fit together poorly, the joint depends on ligaments and on two crescent-shaped pads of cartilage, the menisci, which deepen the joint surface and spread the load.
Two collateral ligaments run along the sides of the joint. The medial collateral ligament (MCL) on the inner side resists forces that push the lower leg outwards relative to the thigh, so that the knee bends inwards (valgus stress). The lateral collateral ligament (LCL) on the outer side resists the opposite force (varus stress). A blow against the outside of the knee therefore stretches the inner side of the joint.
Inside the joint, the two cruciate ligaments cross each other. The anterior cruciate ligament (ACL) prevents the tibia from sliding forwards relative to the femur; the posterior cruciate ligament (PCL) prevents it from sliding backwards. In the anterior drawer test, the examiner pulls the tibia forwards with the knee bent; abnormal forward movement compared with the healthy side indicates an ACL tear. A posterior drawer indicates a PCL tear, typically after the bent knee hits the dashboard in a car accident and the tibia is pushed backwards. Most ACL tears occur without any contact at all, when an athlete lands from a jump or changes direction with the foot planted and the knee turns inwards.
The medial meniscus is firmly attached to the MCL and is therefore less mobile than the lateral meniscus, which is why it is injured more often. A combined injury of the ACL, the MCL and the medial meniscus is known as the unhappy triad. Only the outer third of each meniscus has a blood supply (the red zone); the inner two thirds receive nutrients by diffusion from the joint fluid. Tears in the outer zone can often be sutured and heal, whereas tears in the inner zone heal poorly and are usually trimmed.
| Test | Manoeuvre | Positive result suggests |
|---|---|---|
| Anterior drawer | Tibia pulled forwards, knee bent to 90° | ACL tear |
| Posterior drawer | Tibia pushed backwards, knee bent to 90° | PCL tear |
| Valgus stress | Lower leg pushed outwards, knee slightly bent | MCL injury |
| Varus stress | Lower leg pushed inwards, knee slightly bent | LCL injury |
1. A footballer is tackled from the outside against his planted right knee. Which ligament is most likely stretched?
D: The medial collateral ligament
A blow against the outside pushes the knee inwards and the lower leg outwards: valgus stress. The text says the MCL on the inner side resists exactly this force, so the MCL is stretched.
2. In a patient's injured knee, the tibia can be pushed backwards much further than on the healthy side. Which structure is most likely torn?
D: The posterior cruciate ligament
Backward movement of the tibia is the posterior drawer. The text says the PCL prevents the tibia from sliding backwards, so a positive posterior drawer indicates a PCL tear.
3. Which meniscus tear has the best chance of healing after it has been sutured?
A: A tear in the outer third of the meniscus
Only the outer third (red zone) has a blood supply. The text says tears there can often be sutured and heal, while tears in the inner two thirds heal poorly.
4. Why is the medial meniscus injured more often than the lateral one?
B: It is fixed to the MCL and moves less
The text says the medial meniscus "is firmly attached to the MCL and is therefore less mobile", which is why it is injured more often.
5. A basketball player lands from a jump without being touched and has a positive anterior drawer test. What can be said about the mechanism?
B: It fits the typical non-contact way the ACL tears
Anterior drawer positive means an ACL tear. The text says most ACL tears occur without any contact, when landing or changing direction with the knee turning inwards.
6. An MRI shows a torn ACL, a stretched MCL and a torn medial meniscus. What is this combination called, and which force probably acted on the knee?
A: Unhappy triad; inward turning with the foot planted
The text names the combination of ACL, MCL and medial meniscus the unhappy triad. The MCL is stretched by valgus stress (knee bending inwards), and the ACL tears when the knee turns inwards with the foot planted.
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