18 腹主動脈（abdominal aorta）分枝為左右總腸骨動脈（common iliac artery）處，相當於下列那個

體表位置？

 恥骨聯合上緣 恥骨上緣與臍連線的中點

 臍 橫幽門面（transpyloric plane）

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The ansa cervicalis (or ansa hypoglossi in older literature) is a loop of nerves that are part of the cervical plexus. It lies superficial to the internal jugular vein in the carotid sheath.

Branches from the ansa cervicalis innervate three of the four infrahyoid muscles, including the sternohyoid muscle, the sternothyroid muscle, and the omohyoid muscle.

26 下列有關頸襻（ansa cervicalis）之敘述，何者錯誤？

 其分枝支配肩胛舌骨肌（omohyoid muscle）之上段

 其上根（superior root）源自於第一頸椎神經之腹側枝（ventral ramus）

 貼附於頸動脈鞘（carotid sheath）前外方

 其分枝鎖骨上神經（supraclavicular nerves）負責部分頸部皮膚之感覺

D

28 第六頸椎之水平層面，頸動脈鞘（carotid sheath）並不包裹下列何者？

 頸內動脈（internal carotid artery）  第十顱神經

 頸內靜脈（internal jugular vein）  頸深淋巴結（deep cervical lymph nodes）

The four major structures contained in the carotid sheath are:

• the common carotid artery as well as the internal carotid artery
• internal jugular vein
• the vagus nerve(Cranial nerve 10)
• the deep cervical lymph nodes.

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35 一位52 歲婦女因下背痛六個月而求醫。最近三個月來病人感覺倦怠、頭痛，理學檢查有貧血、頭部

及四肢有壓痛感，實驗室檢查：血紅素（Hb）9.2 gm/dL、紅血球沉降速度（ESR）140 mm/hr、尿酸

7.6 mg/dL、血清總蛋白12.8 gm/dL、白蛋白2.5 gm/dL、尿蛋白+++陽性、腰椎X-ray L4-5 壓迫性骨

折，下列那一項是診斷此病最重要之檢查？

 血清肌酸酐（creatinine）  胸部X 光

 骨髓穿刺 抗核抗體（ANA）

c

multiple myeloma

Because many organs can be affected by myeloma, the symptoms and signs vary greatly. A mnemonic sometimes used to remember the common tetrad of multiple myeloma is CRAB: C = Calcium (elevated), R = Renal failure, A = Anemia, B = Bone lesions.^[2] Myeloma has many possible symptoms, and all symptoms may be due to other causes. They are presented here in decreasing order of incidence.

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38 一位37 歲婦女工廠作業員，因最近二週逐漸四肢無力求診。六個月前病人有眼瞼（eyelid）腫及乾

眼現象，兩個月前在上眼瞼及手指邊出現紅斑，一個月前無法舉高雙手及無法從座椅上站起來，下

列那一種檢查是最重要之檢查？

 白血球數目 下肢X-ray

 Creatine phosphokinase  免疫球蛋白

c

上眼瞼及手指邊出現紅斑: heliotrope and gottron's sign.

proximal muscle weakness

this is a case of

DERMATOMYOSITIS