Miscellaneous
A 35-year-old female is under general anesthesia. Prior to laryngeal intubation, the rima glottidis is opened by which pair of muscles?
A. Posterior cricoarytenoids
B. Lateral cricoarytenoids
C. Thyroarytenoids
D. Transverse arytenoids
E. Cricothyroids
A. Posterior cricoarytenoids
The parasympathetic preganglionic nerve cell body for CN IX is located in the:
Superior salivatory nucleus
Lacrimal nucleus
Ambiguus nucleus
Inferior salivatory nucleus
Edinger westphal nucleus
Intermediate lateral gray horn
Inferior salivatory nucleus
An epidural hematoma consists of blood from which vessel?
Middle meningeal artery
Cerebral veins
Internal carotid artery
Circle of willis
Vertebral artery
Middle meningeal artery
The cerebrospinal fluid drains into the:
Ventricles 3 and 4
Inferior sagittal sinuses
Confluence of sinuses
Ventricles 1 and 2
Superior sagittal sinus
Superior sagittal sinus
All cell bodies of the preganglionic sympathetic fibers to the head are located in the:
Superior cervical ganglion
Posterior gray horn of segments of T1 to T3
Intermediate lateral gray horns of segments T1 to T3
Lateral gray horns of segments S2 to S4
Anterior gray horn of segments of T1 to T3
Intermediate lateral gray horns of segments T1 to T3
Elevation and lateral movement of the lips to create a smile is facilitated by which of the following muscles?
Orbicularis oris
Orbicularis oculi
Levator palpebrae superioris
Depressor anguli oris
Zygomaticus major
What is zygomaticus major?
A 55-year-old woman is diagnosed with a tumor at the base of the skull, resulting in a decrease in tear production. Which of the following nerves is most likely injured?
A. Chorda tympani
B. Deep petrosal
C. Greater petrosal
D. Lesser petrosal
E. Nasociliary
C. Greater petrosal
A 59-year-old man is admitted to the emergency department with acute pain on his mandible. An MRI examination reveals an acute inflammation of the TMJ due to arthritis. Which of the following muscles will most likely be affected by the inflammatory process of the TMJ?
A. Temporalis
B. Medial pterygoid
C. Masseter
D. Lateral pterygoid
E. Buccinator
D. Lateral pterygoid
50 year-old patient arrives at the ER complaining of the worst headache of his life and is diagnosed with subarachnoid hematoma. Which of the following vessels would be the most likely source of bleeding?
Cerebral (“Bridging”) vein
Internal carotid artery
Middle meningeal artery
Sigmoid Sinus
Anterior Communicating artery
Anterior Communicating artery
The middle cervical sympathetic ganglion, recurrent laryngeal nerve, and parathyroid glands are all closely related with which blood vessel?
Inferior thyroid artery
Inferior thyroid vein
Superior thyroid artery
Superior thyroid vein
Inferior thyroid artery
Cerebrospinal fluid mainly is found in the ventricles of the brain and in this space around the CNS. What is this space?
Epicranial
Subpial
Subarachnoid
Epidural
Subdural
Subarachnoid
In the examination room, the physician needs to determine the integrity of several cranial nerves. Which of the following tests is most specific for assessing the function of the cranial nerve IX?
Ask patient to turn head against resistance
Ask the patient to protrude the tongue
Eliciting the gas reflex **
Have the patient to “Ahhhhh” and observe vocal cords
Have patient to “Ahhhh” and observe the uvula
Eliciting the gas reflex
While recovering from a right facial paralysis accident, a 36-year old female patient complained that food accumulated between the teeth and the cheek mucosa when chewing. The deficiency of which muscle was most likely the cause of the chewing problem?
Zygomaticus major
Orbicularis oris
Buccinator
Levator labii superioris
Buccinator
A 48-year-old man presents with a constricted right pupil that does not react to light. His left pupil and vision in both eyes are normal. These findings are most likely due to a lesion involving which of the following right-sided structures?
A. Oculomotor nerve
B. Superior cervical ganglion
C. Nervus intermedius
D. Edinger-Westphal nucleus
E. Trigeminal (semilunar) ganglion
B. Superior cervical ganglion
A 55-year-old woman is admitted to the hospital with difficulty swallowing. Physical examination reveals that the patient has episodes of severe headaches and frequently aspirates fluids when drinking them. A radiographic examination reveals a skull base tumor occupying the space behind the jugular foramen. Involvement of which of the following structures is most likely responsible for the findings in the patient?
A. Ansa cervicali
B. Cervical sympathetic trunk
C. External laryngeal nerve
D. Hypoglossal nerve
E. Vagus nerve
E. Vagus nerve
A 33-year-old woman is unconscious when she is admitted to the hospital after she fell, hitting her head. The physician in the emergency department performs a pupillary light reflex test, and the pupils constrict. Where is the location of the presynaptic neuron’s cell body being checked?
A. Edinger-Westphal
B. Lacrimal
C. Superior Salivatory
D. Inferior Salivatory
E. Intermediate Lateral Gray Horn
F. Dorsal Root Ganglion
A. Edinger-Westphal
The largest structure passing through the cavernous sinus is the:
Trigeminal (mandibular division)
Abducens nerve
Internal carotid artery
Internal jugular vein
Internal carotid artery
A 54-year-old man was admitted to the emergency department after he was struck by an automobile. Radiographic examination revealed a fracture through the crista galli of the anterior cranial fossa, resulting in slow, local bleeding. Which of the following is the most likely source of bleeding?
A. Middle meningeal artery
B. The great cerebral vein of Galen
C. Superior sagittal sinus
D. Straight venous dural sinus
E. Superior ophthalmic vein
C. Superior sagittal sinus
A 68-year-old woman is suffering from excruciating, sudden bouts of pain over the area of her midface. Laboratory studies indicate that she has tic douloureux (trigeminal neuralgia). Which ganglion is the location of the neural cell bodies of the nerve mediating the pain?
A. Geniculate
B. Trigeminal (semilunar)
C. Inferior glossopharyngeal
D. Otic
E. Pterygopalatine
B. Trigeminal (semilunar)
A 24 year old patient admitted to the dental clinic with acute dental pain. The attending dentist found penetrating dental caries (tooth decay) affecting one of the mandibular molar teeth. Which of the following nerves would the dentist need to anesthetize to remove the caries in that tooth?
Lingual
Inferior alveolar
Buccal
Mental
Mylohyoid
Inferior alveolar
A 22-year-old woman is admitted to the hospital with an injury to her eye. The corneal reflex is tested and found to be present. Which of the following nerves is responsible for the afferent limb of this reflex?
A. Frontal
B. Lacrimal
C. Nasociliary
D. Oculomotor
E. Optic
C. Nasociliary
A 20-year-old man is admitted to the emergency department with a stab wound in the superior region of his neck. A radiographic examination reveals that the wound has not affected any major structures. Physical examination reveals that the patient has lost sensation from the skin over the angle of the jaw. Which of the following nerves is most likely injured?
A. Supraclavicular
B. Transverse cervical
C. Great auricular
D. Greater occipital
E. Lesser occipital
C. Great auricular
A 48-year-old man presents with a constricted right pupil that does not react to light. His left pupil and vision in both eyes are normal. These findings are most likely due to a lesion involving which of the following right-sided structures?
Oculomotor Nerve
Superior Cervical Ganglion
Nervus Intermedius
Edinger-Westphal Nucleus
Trigeminal (Semilunar) ganglion
Superior Cervical Ganglion
The external carotid artery terminates within the parotid gland, just behind the neck of the mandible where the external carotid artery gives off two final branches. Which 2 arteries below are those final branches?
Superior thyroid artery and posterior auricular artery
Superficial temporal artery and maxillary artery
Posterior auricular artery and occipital artery
Occipital artery and facial artery
Inferior thyroid and transverse facial
Superficial temporal artery and maxillary artery
During childbirth, an excessive anteroposterior compression of the head may tear the anterior attachment of falx cerebri from the tentorium cerebelli. The bleeding that follows is likely to be from which of the following venous sinuses?
Occipital Sinus
Sigmoid Sinus
Straight Sinus
Superior Sagittal Sinus
Transverse Sinus
Straight Sinus
A fourth year ER resident had to start a subclavian venous catheter (Central line placement) using the infraclavicular approach on a 17 year-old female who was the driver in a head-on automobile crash. Later, the patient experienced difficulty breathing. What nerve may have been damaged?
Vagus
Recurrent laryngeal
Olfactory
Phrenic
Auriculotemporal
Phrenic
Patient has a tumor that is compressing a nerve, as a result he lost sensation on the roof of her mouth. One potential location of the tumor is:
Pterygopalatine fossa
Nasopharynx
Orbit
Infratemporal fossa
Anterior cranial fossa
Pterygopalatine fossa
A 54-year-old man is admitted to the hospital due to severe headaches. A CT examination reveals an internal carotid artery aneurysm inside the cavernous sinus. Which of the following nerves would be typically affected first? (Select two answers)
A. Abducens nerve
B. Optic nerve
C. Ophthalmic nerve
D. Mandibular nerve
E. Facial
A. Abducens nerve and C. Ophthalmic nerve
A 27-year-old woman is admitted to the emergency department after she was thrown from a motor scooter. Radiographic evaluation reveals a type 1 Lefort fracture and comminuted fracture of the mandible and TMJ. Despite reconstructive surgery, the patient develops hyperacusis (sensitivity to loud sounds) due to facial nerve paralysis. Which of the following muscles is most likely paralyzed?
A. Posterior belly of digastric
B. Stapedius
C. Tensor tympani
D. Stylohyoid
E. Cricothyroid
B. Stapedius
A 26 year-old African-American female who is using hormonal birth control and has peripheral vascular disease arrives at the ER with symptoms of vomiting and loss of consciousness. The infract shown in the MRI scan was most likely an occluded artery that is a continuation of the internal carotid artery to help supply the brain. Which artery is occluded?
Anteromedial central arteries
Anterolateral central arteries
Anterior Cerebral
Posterior Cerebral
Middle Cerebral
Middle Cerebral
An otolaryngologist examines an 11-year-old boy with swollen palatine tonsils. Which of the following arteries supplies most of the blood to these tonsils and must be protected when its tonsillar branch is divided?
Ascending Pharyngeal
Facial
Lingual
Descending Palatine
Superior Thyroid
Facial
My teenage daughter has been complaining of stiff neck and fever along with a change in mental condition. In the past couple of days, she has become more fatigue and confused. Bacterial meningitis has been reported at her school and is suspected in this case. Her doctor orders a lumbar puncture to withdraw cerebral spinal fluid. What structure would not be pierced/ transverse during this procedure?
Arachnoid mater
Pia mater
Epidural space
Dura mater
Subarachnoid space
Pia mater
An unconscious 48-year-old woman is admitted to the hospital. CT scan reveals a tumor in her brain. When she regains consciousness, her right eye is directed laterally and downward, with complete ptosis of her upper eyelid, and her pupil is dilated. Which of the following structures was most likely affected by the tumor to result in these symptoms?
A. Oculomotor nerve
B. Optic nerve
C. Facial nerve
D. Ciliary ganglion
E. Superior cervical ganglion
A. Oculomotor nerve
A 30 year-old female goes to an outpatient clinic and complains of dry mouth. The physician diagnoses the patient with sialolithiasis, a condition where tiny salivary stones (sialoliths) form in the glands and may block the ducts. The duct of the submandibular gland empties into the oral cavity:
Opposite the lower second molar tooth
At the base of the tongue via the foramen caecum
Via several small openings along the sublingual fold
Opposite the second maxillary molar tooth
Beside the lingual frenulum through the sublingual caruncle
Beside the lingual frenulum through the sublingual caruncle
A 7-year-old boy was suffering from a severe infection of the middle ear (otitis media), which spread to the mastoid air cells (mastoiditis). Surgery was required but resulted in the following: right corner of the mouth drooping, unable to close his right eye, food collection in his right oral vestibule. Which nerve was injured?
A. Glossopharyngeal
B. Vagus
C. Facial
D. Maxillary division of the trigeminal nerve
E. Mandibular division of the trigeminal nerve
C. Facial
A 32-year-old woman is admitted to the hospital with headaches and dizziness. During physical examination it is noted that the patient has partial ptosis (drooping eyelid). Which of the following muscles is most likely paralyzed?
A. Orbicularis oculi, lacrimal part
B. Orbicularis oculi, palpebral part
C. Levator palpebrae superioris
D. Superior oblique
E. Superior tarsal (of Muller)
E. Superior tarsal (of Muller)
A 63-year-old man with hearing loss in his left ear complains of a loss of taste and drooling from the left side of his mouth. A CT Scan shows a tumor compressing the nerve exiting the skull. After several months of chemotherapy, all symptoms were gone except loss of taste to the anterior portion of the tongue. Where is the damaged cell body possibly located?
Geniculate ganglion
Trigeminal ganglion
Intermediate Lateral Gray Horn
Superior Cervical Ganglion
Otic Ganglion
Geniculate ganglion
An innocent pedestrian was shot in the neck region. The stray bullet severed a major structure at the level of cervical vertebra 3. The severed structure carries postsynaptic sympathetic fibers to the head and contributes greatly to cerebral circulation. Which of the following structures was most likely severed?
A. Cavernous sinus
B. Internal jugular vein
C. Facial artery
D. Internal carotid artery
E. Ophthalmic vein
D. Internal carotid artery
A 45-year-old woman is admitted to the hospital for severe ear pain. Physcial examination reveals chronic infection of the mastoid air cells (mastoiditis), The infection can erode the thin layer of the bone between the mastoid air cells and the posterior cranial fossa and spread most commonly into which of the following venous structures?
Superior Sagittal sinus
Inferior Sagittal sinus
Straight Sinus
Cavernous Sinus
Sigmoid Sinus
Sigmoid Sinus
A 31-year-old female is admitted to the hospital after an automobile collision. A CT scan examination reveals a large hematoma inferior to the right jugular foramen. Physical examination reveals right pupillary constriction (miosis) and anhydrosis of the face. Which of the following ganglia is most likely affected by the hematoma?
A. Submandibular
B. Trigeminal (semilunar)
C. Superior cervical
D. Geniculate
E. Ciliary
C. Superior cervical
A 32-year-old female patient asks you what is the soft, thin ridge of tissue that she can feel running forward across the masseter muscle toward her upper lip. You reassure her that is perfectly normal. Which of the following is the most likely structure she is feeling?
A. Facial artery
B. Maxillary artery
C. Parotid duct
D. Marginal mandibular branch of facial nerve
E. Facial vein
C. Parotid duct
A 68-year-old man is admitted to the emergency department after an acute cerebral vascular accident (stroke). Radiographic studies reveal that the primary damage was to the anterior inferior cerebellar artery, resulting in a small hemorrhage of the artery at is origin from the main trunk. Which of the following nerves will most likely be immediately affected by the hemorrhage?
A. Optic nerve
B. Oculomotor nerve
C. Trochlear nerve
D. Trigeminal nerve
E. Abducens nerve
E. Abducens nerve
A 65-year-old male is admitted to the hospital three weeks after a "small bump of his head" according to his narrative. He suffered the accidental bump from a low-hanging branch while driving his tractor through the apple orchard during harvesting season. During physical examination, the patient displays mental confusion and poor physical coordination. Radiographic examination reveals leakage from a cerebral vein over the right cerebral hemisphere. From what type of bleeding is the patient most likely suffering?
A. Subarachnoid bleeding
B. Epidural bleeding
C. Intracerebral bleeding into the brain parenchyma
D. Subdural bleeding
E. Bleeding into the cerebral ventricular system
D. Subdural bleeding
A 68-year-old woman is suffering from excruciating, sudden bouts of pain over the area of her midface. Laboratory studies indicate that she has tic douloureux (trigeminal neuralgia). Which ganglion is the location of the neural cell bodies mediating the pain?
Geniculate
Trigeminal (Semilunar)
Inferior glossopharyngeal
Otic
Pterygopalatine
Trigeminal (Semilunar)
A 40-year-old unconscious man is admitted to the emergency department after being hit in the head with a baseball. A CT scan examination reveals a fractured pterion and an epidural hematoma. Branches of which of the following arteries are most likely to be injured?
A. External carotid
B. Superficial temporal
C. Maxillary
D. Deep temporal
E. Middle meningeal
E. Middle meningeal
A 21-year-old male baseball player is brought to the emergency department after feeling severe dizziness. During physical examination, the patient demonstrates lack of equilibrium and memory impairment. A 3-cm wound is noted in his scalp from an injury suffered in a game several weeks earlier. A lumbar puncture does not reveal blood in the cerebrospinal fluid. Which of the following is the most likely diagnosis?
A. The middle meningeal artery was torn, resulting in epidural hematoma.
B. There is a fracture in the pterion with injury to the adjacent vasculature.
C. The injury resulted in the bursting of a pre-existing aneurysm of the anterior communicating artery of the cerebral circle.
D. A cerebral vein is torn.
E. The cavernous sinus has a thrombus.
D. A cerebral vein is torn.
A 50-year old woman complained of pain over her chin and lower lip. A few days later, small vesicles appeared over the same area and soon began erupting. She was diagnosed with a dermatomal herpes zoster inflammation (shingles). Which of the following nerves was most likely responsible for the transmission of the virus in this case?
A. Auriculotemporal
B. Buccal
C. Lesser petrosal
D. Mental
E. Infraorbital
D. Mental
You wake up one morning to discover that your alarm has not worked and you are running late. Desperate to get to your Anatomy lecture in time, yet unbearably hungry, you quickly throw some bread in the toaster as you prepare. Despite the toast burning a little, you devour it as you rush out the door. The burnt parts of the toast scratch the roof of your mouth, leaving you with a stinging sensation there. What nerve is collecting this sensation from the hard palate?
Posterior superior alveolar nerve
Inferior alveolar nerve
Lingual Nerve
Greater Palatine Nerve
Lesser Palatine Nerve
Greater Palatine Nerve
A 55-year-old woman is admitted to the hospital with severe hypertension. Laboratory examination reveals hypertension (190/110 mm Hg) and hypercholesterolemia (250/mg/dl). During physical examination, the patient complains of headaches and dizziness. Radiographic examination reveals 90% occlusion of both common carotid arteries. A carotid endarterectomy is performed and large atherosclerotic plaques are removed. During a postoperative physical examination on the right side, it was noted that her tongue deviated toward the right when she was asked to stick it out. Which of the following nerves was most likely injured during the procedure?
A. Right glossopharyngeal
B. Right hypoglossal
C. Left hypoglossal
D. Left lingual
E. Left vagus
B. Right hypoglossal