INI-CET High Yield Questions for Anatomy

Mastering the INI-CET demands a strategic approach to preparation, with an emphasis on high-yield topics proving to be a successful tactic. This blog zeroes in on exactly that – a curated list of high-yield questions in Anatomy that are highly likely to appear on the INI-CET. By acquainting yourself with these questions and their detailed explanations, you'll deepen your understanding of Anatomy concepts, enhancing your confidence and readiness for exam day.

1. A 5-year-old boy with swelling, tenderness, redness in his lower left leg, a raised red line extending towards the groin, and a fever of 38.5°C (101.3°F), identify the cell junction implicated in the observed inflammation.

A. Tight junction

B. Zona adherens

C. Macula adherens

D. Gap junction

Option B: Zona adherens

• This decrease in cell adhesion is most likely due to a continuous band passing all around the apical part of the epithelial cell known as zona adherens.
• It has a 20 nm intercellular gap.
• Filaments do not traverse the gap between the thickenings of the plasma membrane.
• The zonula adherens junction lies below the zonula occludens. E-Cadherin is a protein present between the two cells. The cadherins from nearby cells interact with each other for adhesion.
• E-cadherin binds to catenin inside the cell, which binds to other proteins (vinculin, alpha-actinin) in a protein complex with actin filaments.
• The actin filaments are arranged circumferentially around the cell into a marginal band. This band can deform and contract the shape of cells held together in this way - this is thought to be key in the morphogenesis of epithelial cells in forming ducts.

Option A: Tight junction

• Tight junction also known as Zona Occludens
• Act as barriers that prevent the movement of molecules into intercellular spaces.

Option C: Macula adherens

• Macula adherens also known as desmosomes
• 25nm intercellular gap.
• The thickened areas of the two membranes are held together by fibrils that appear to pass from one membrane to the other across the gap (cadherins) (autoimmune destruction of cadherins → pemphigus Vulgaris)
• Hemidesmosomes: Attach the Cell to the basement membrane (destroyed in → bullous pemphigoid).

Option D: Gap junction

• Gap junction also known as Maculae Communicans
• Made up of connexons that allow free exchange between cells along a concentration gradient.
• It can also act as an electrical synapse.

2. A 59-year-old man presents to the emergency ward 25 minutes after the sudden onset of severe chest pain radiating to his jaw. He has hypertension and a history of smoking. His blood pressure readings differ between arms. Which type of junction is NOT present in this cell?

A. Zonula occludens

B. Zonula adherens

C. Macula adherens

D. Gap junction

Option A: Zonula occludens

• In the given diagram, we can see some striations (alternate bands of light & dark structures)
• The arrow mark shows an intercalated disc (intercellular junction)
• This is cardiac muscle as there is the perinuclear halo
• Tight junctions (Zona occludens) are absent in this.

Option B: Zonula Adherens

• The given diagram is regarding the cardiac muscle
• Zona adherens are present in the intercellular junction providing adhesion for the adjacent fibers

Option C: Macula adherens

• The Cardiac Muscle develops by joining the cells end to end through anchoring cell junctions called the Intercalated Discs that form the distinguishing feature of Cardiac Muscles.
• Inter-digitating intercalated discs are composed of Fascia adherens, Desmosomes, and Gap Junctions.
• Desmosomes are also known as macula adherens

Option D: Gap junction

• Inter-digitating intercalated discs are composed of Fascia adherens, Desmosomes, and Gap Junctions.
• Gap junctional passages are low resistance passages that allow Free passage of ions from one cell to others they are found in the heart, Smooth muscles in the wall of the gut, and protein is made up of made of 6 connexons.

3. A 55-year-old woman presents with progressive neck pain, stiffness, and inability to move her neck laterally or medially. Which structures are involved in the patient's pathology?

A. Atlanto-occipital joint

B. Atlanto-axial joint

C. C2-C3 articulation

D. C6-C7 articulation

Option B: Atlanto-Axial joint

• This is a case of atlantoaxial joint dysfunction, which is most likely caused due to degenerative changes.
• Side-to-side movement is due to the C1 – C2 joint called an atlantoaxial joint.
• Atlas is C1 bone; Axis is C2 bone; the dens of C2 will fit into the atlas bone-forming atlantoaxial joint.

Option A: Atlanto-occipital joint

• Atlantooccipital joint (Ellipsoidal synovial joint) causes yes movement/nodding movement.
• Atlanto - occipital joint
  • For head nodding
  • Ellipsoid synovial/condylar joint
• The vertebral artery comes from the foramen transversarium & arches over the superior surface of the atlas vertebra (Posterior arch) & enters the cranial cavity by passing through the foramen magnum upwards.​​​​​​​

Option C: C2-C3 articulation

• C2-C3 articulation allows the flexion and extension of the movement
• For example touching of the chin towards the chest and movement of the head backwards

Option D: C6-C7 articulation

• This helps in giving flexibility to the neck and supports the cervical spine and head.

4. A 38-year-old male presents with a burning sensation in the lateral margin of the little toe and a weak ankle reflex. No other abnormalities are noted, and the patient has no chronic illness history. Which of the following intervertebral disc is likely to have prolapsed? 

A. L5-S1

B. L2-L3

C. L1-L2

D. L4-L5

Correct Option A: L5-S1

• It is a case of tibial nerve compression in which the patient has decreased ankle jerk.
• The tibial nerve is associated with the posterior compartment of the leg.
• It is a major sciatic nerve branch that descends into the posterior compartment from the popliteal fossa.
• The tibial nerve passes under the tendinous arch formed between the fibular and tibial heads of the soleus muscle and passes vertically through the deep region of the posterior compartment of the leg at the ankle by passing through the tarsal tunnel behind the medial malleolus.
• It enters the foot to supply most intrinsic muscles and skin.
• In the leg, the tibial nerve gives rise to:
  • Branches that supply all muscles in the posterior compartment of the leg
  • Two cutaneous branches are the sural nerve and the medial calcaneal nerve.
• Branches of the tibial nerve that innervate the superficial group of muscles of the posterior compartment and the popliteal muscle of the deep group originate high in the leg between two heads of the gastrocnemius muscle in the distal region of the popliteal fossa.

Option B,C, and D are incorrect

• In a case of tibial nerve compression the slip disc is between L5 and S1 .

5. In a 35-year-old woman with a regular 28-day menstrual cycle who has been trying to conceive for 8 years and has missed her period, during which week of embryonic development will she experience her first missed menstrual period?

A. Start of week 3

B. Start of week 4

C. Start of week 5

D. Start of week 6

Option A: Start of week 3

• The time a woman notices a missed menstrual period implies that the fertilization process has already happened. Based on the knowledge of the duration of a woman’s menstrual cycle duration, the age of the embryo at the time of missed period can be estimated.
• An average menstrual cycle is assumed to be 28 days in duration.
• The menstrual phase starts from day 1 to day 5 of the menstrual cycle, and the follicular phase starts from day 6 to day 12 of the menstrual cycle.
• Fertilization can occur between days 14-15 of the menstrual cycle.
• If implantation occurs, the woman notices missing the next menstrual period from day 1 to day 5. That day corresponds to the start of the third week of embryonic development (day15→day28→day1-5 of the next cycle adds up to about 14 to 19 days).
• In this case, the menstrual cycle has been assumed to be 28 days.
• This average can vary from case to case 28 +/- 7 days.

Option B,C,D

• Assuming the average menstrual cycle of 28 days, the time of the missed menstrual period corresponds to the beginning of week 3.

Also Read: INI-CET Previous Year Question Papers

6. According to the figure below, Which of the following is correct regarding the attachments of external oblique muscle?

A. I.Linea alba, II - Linea semilunaris, III - Inner lip of iliac crest, IV - Inguinal ligament

B. I - Linea alba, II - Linea semilunaris, III - Outer lip of iliac crest, IV - Inguinal ligament

C. I - Linea semilunaris, II - Linea alba, III - Outer lip of iliac crest, IV - Inguinal ligament

D. I - Linea semilunaris, II - Arcuate line, III - Inner lip of iliac crest, IV - Inguinal ligament

7. A 34-year-old woman presents to the emergency department with severe thigh pain. A mass is palpated below the inguinal ligament, diagnosing a strangulated femoral hernia. What structure would be immediately lateral to the herniated structures?

A. Femoral Vein

B. Femoral Artery

C. Pectineus Muscle

D. Femoral Nerve

Option A: Femoral Vein

• A femoral hernia is situated below the inguinal ligament and is present in females only as the femoral ring through which the abdominal contents protrude is larger in females
• If the hernia gets strangulated, it can cause a lot of pain and has to be surgically treated
• In the case of a femoral hernia, the contents of the abdomen are pressed through the femoral ring, which is directly lateral to the lacunar ligament and just medial to the femoral vein.
• The femoral vein would be immediately lateral to the femoral hernia.

Option B: Femoral artery

• The femoral artery is lateral to the femoral vein

Option C: Pectineus muscle

• The pectineus muscle is situated inferiorly to the femoral ring

Option D: Femoral nerve

• The femoral nerve is most lateral and is lateral to the femoral artery and vein.

8. A bulge known as the Torus aorticus is present superior to the coronary sinus and anterior to the fossa ovalis on the interatrial septum. Which of the following structures is the most likely reason for the bulge?

1. Atrium bulging into the aorta
2. Aortic sinus bulging into the left atrium
3. Aortic sinus bulging into the right atrium
4. Aortic wall tear

Correct Option C: Aortic sinus bulging into the right atrium.

• Torus aorticus is the prominent region of the right atrial septum located superiorly and anteriorly. It is superior to the coronary sinus and anterior to the fossa ovalis. It represents the deeper and anterior surface of the posterior sinus and cusp of the aortic valve.
• The interatrial septum is a thin wall between the right and the left atria. It has a depression known as fossa ovalis. The fossa ovalis has a prominent margin known as annulus ovalis or limbus. There is a bulge in the right atrial septum, which is anterior to the fossa ovalis and superior to the opening of the coronary sinus. This bulge is known as the Torus aorticus.
• The torus aortic (aortic mound) is the prominent region of the right atrial septum, which marks the projection of the non-coronary aortic sinus into the right atrial wall.
• The aortic sinus has three parts, the anterior aortic sinus, the left posterior aortic sinus and the right posterior aortic sinus. The right coronary artery arises from the anterior aortic sinus. The left coronary artery arises from the left posterior aortic sinus. The right posterior aortic sinus (non-coronary sinus) does not give off any artery. It forms a bulge in the right atrial septum known as the Torus aorticus (aortic mound).

Incorrect Options: 

Option A: Atrium bulging into the aorta.

• Torus aorticus (aortic mound) is not produced by the bulging of the atrium into the aorta. It is produced by the bulging of the non-coronary aortic sinus into the right atrial septum.

Option B: Aortic sinus bulging into the left atrium.

• The Torus aorticus (aortic mound) is not produced by the bulging of the non-coronary aortic sinus into the left atrium. It is produced by the bulging of the aortic sinus into the right atrial septum.

Option D: Aortic wall tear.

• The Torus aorticus (aortic mound) is not produced by aortic wall rupture. It is produced by the bulging of the non-coronary aortic sinus into the right atrial septum.
• Aortic wall tear will lead to aortic dissection or aortic rupture.
• Aortic rupture can be caused by trauma, and a widened mediastinum will be seen on the chest radiograph.
• Aortic dissection presents with sudden onset chest pain radiating to the back and unequal arm pulses and blood pressures. It can lead to organ ischemia, aortic rupture or death.

9. A 30-year-old man comes to the office to evaluate numbness and tingling sensations in the palm and fingers. On evaluation, there is also weakness in the hands. He is diagnosed with pronator teres syndrome. It is due to the involvement of which of the following nerves?

1. Radial nerve
2. Axillary nerve
3. Ulnar nerve
4. Median nerve

Option D: Median nerve

• Pronator teres syndrome is the compressive neuropathy of the median nerve at the elbow level, compressed between the heads of the pronator teres (PT) near the elbow.
• Quick and repetitive grasping or pronation movements (prolonged hammering, ladling food, cleaning dishes, tennis) may cause PT muscle hypertrophy and entrapment of MN, especially in individuals with additional fibrous brands.
• It manifests with pain in the volar forearm region, aggravated by resisted forearm pronation and elbow flexion, and positive Tinel's sign over the proximal edge of PT. The patient may report significant weakness in the distribution of the median nerve.
• Pronator teres syndrome has a sensory loss in the entire median nerve distribution.

Incorrect Options:

Option A: Radial nerve

• The radial nerve is injured in the mid-shaft fracture of the humerus.

Option B: Axillary nerve

• It is injured during surgical procedures in the axillary region.

Option C: Ulnar nerve

• Ulnar nerve is compressed in Guyon's canal, leading to tingling and numbness in the ulnar nerve distribution.

10. A 70-year-old woman presents with symptoms including visual loss, nausea, vomiting, weakness, menstrual changes, sexual dysfunction, increased urine, and unintended weight changes. MRI shows an enlarged pituitary gland located in the sella turcica, immediately posterior and superior to which structure?

A. Frontal sinus

B. Sphenoid sinus

C. Ethmoid air cells

D. Mastoid air cells

Correct Option B - Sphenoid sinus:

• The pituitary gland lies in the hypophyseal fossa of sella turcica of the sphenoid bone, which lies immediately superior and posterior to the sphenoid sinus and medial to the cavernous sinus.
• The sphenoidal sinus is an air cavity within the body of the sphenoid bone. It is a midline structure located anterior to the clivus and posterior to the superior meatus of the nasal cavity.

Incorrect Options:

Option A - Frontal sinus:

• Frontal sinuses are a pair of small, air-filled cavities located just behind your eyes in the brow region. Along with three other pairs of paranasal sinuses, these cavities produce a thin mucus that drains through your nasal passages.

Option C - Ethmoid air cells:

• The ethmoid sinuses are within the ethmoid bone and are divided into two compartments, the anterior and posterior.
• The anterior ethmoid sinus drains into the middle meatus, and the posterior ethmoids drain into the sphenoethmoidal recess.

Option D - Mastoid air cells:

• At the superior and anterior part of the mastoid process, the air cells are large and irregular and contain air, but toward the inferior part, they diminish in size. In contrast, those at the apex of the process are frequently quite small and contain marrow. Occasionally, they are absent.
• Mastoid air cells communicate with the middle ear via the mastoid antrum and the aditus ad antrum.

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