Nose and Paranasal Sinus
Orbit
Ear
Larynx
Pharynx
Lungs and Bronchi
Pericardium and heart
100
The anterior ⅓ of the nasal cavity and septum receives sensory innervation from:
CN I
CN V1
CN V2
CN V3
CN VII
what is CN V1 ?
100
Which foramen allows communication between the cranial cavity and the orbit?
Carotid canal
Cribriform plate
Optic canal
Foramen ovale
Inferior orbital fissure
what is optic canal?
100
Which of the following fluids are found in the cochlea?
- Perilymph
- Endolymph
- Both
what is both?
100
A woman undergoes surgery on her thyroid gland. During the operation the nerve accompanying the superior thyroid artery is damaged. The function of which of the following muscles will be affected by this?
Cricothyroid
Superior pharyngeal constrictor
Omohyoid
Trapezius
what is cricothyroid?
100
Which muscle of the soft palate is associated with the hamulus?
Levator veli palatini
Musculus uvulae
Palatoglossus
Palatopharyngeus
Tensor veli palatini
what is tensor veli palatini?
100
Which feature is found only in the left lung?
Cardiac notch
Horizontal fissure
Oblique fissure
Superior lobar bronchus
Three lobes
what is cardiac notch?
100
An artificial cardiac pacemaker is implanted in a 66 year old patient. The conductive tissues of the heart that is not properly functioning is just to the:
Myocardium
Endocardium
Epicardium
Fibrous pericardium
Serous parietal pericardium
what is endocardium?
200
Which of the following drains into the inferior meatus?
Frontal sinus
Maxillary sinus
Middle ethmoid air cells
Nasolacrimal duct
Sphenoid sinus
what is nasolacrimal duct?
200
During normal eye movements, which pair of muscles causes the eye to elevate?
Inferior rectus and inferior oblique
Inferior rectus and superior oblique
Superior rectus and inferior oblique
Superior rectus and superior oblique
Superior oblique and inferior oblique
what is superior rectus and inferior oblique?
200
Which ganglion contains sensory cell bodies for neurons that travel in the facial nerve?
Ciliary
Geniculate
Otic
Pterygopalatine
Submandibular
what is geniculate?
200
A 31-year-old woman visits her general practitioner with globus sensation (feeling of a lump in the throat) and increase in neck circumference. In the clinical examination the thyroid gland is palpated. With what structure does the thyroid gland normally elevate with swallowing?
Larynx
Thymus
Trachea
Esophagus
what is larynx?
200
Which of the following is found between the palatoglossal and palatopharyngeal arches?
Choanae
Palatine tonsil
Pharyngeal recess
Pharyngeal tonsil (Adenoids)
Torus tubarius
what is palatine tonsil?
200
The pleural space into which lung tissue just above the cardiac notch would tend to expand during deep inspiration is the:
- Anterior mediastinum
- Costodiaphragmatic recess
- Costomediastinal recess
- Cupola
- Pulmonary ligament
what is the costomediastinal recess?
200
Which of the following coronary vessels is most often involved in myocardial infarction?
Left anterior descending
Left circumflex
Left main
Posterior descending
Right main
what is left anterior descending?
300
The most common site of nosebleeds is the area of Kiesselbach's plexus. This is located on the:
Anterior part of the nasal septum
Anterior part of the lateral nasal wall
Posterior part of the nasal septum
Posterior part of the lateral nasal wall
what is anterior part of the nasal septum?
300
A woman suffers a severe head injury. Upon examination you notice that she has ptosis on one side. This could be a result of loss of innervation to the:
Frontalis
Levator palpebrae superioris
Orbicularis oris
Superior oblique
Superior rectus
what is orbicularis oris?
300
A patient with a facial nerve paralysis suffers from reduced ability to dampen loud noises because of denervation of the:
Organ of Corti
Posterior belly of digastric
Stapedius
Tensor tympani
Tympanic membrane
what is stapedius?
300
The ambulance arrives at the scene of a car accident with one injured passenger. The paramedic observes a clouding of the patient’s consciousness. Furthermore , he cannot feel the peripheral pulse at the radial artery which is why he carries on palpating the central pulse for comparison. Which artery is the recommended site to assess the central pulse in adults?
Brachiocephalic trunk
Common carotid
Subclavian artery
Vertebral artery
what is common carotid?
300
You see a patient’s left hypoglossal nerve being damaged. Which of the following would you expect to see?
Loss of pain sensations on the left side of the tongue
Loss of taste sensations on the left side of the tongue
When asked to stick out her tongue, it will deviate towards the left
When asked to stick out her tongue, it will deviate towards the right
Your patient’s ability to protrude the tongue is normal
what is when asked to stick out her tongue, it will deviate towards the left?
300
A sick person, lying supine in bed, aspirates (breathes in) some fluid into her lungs while swallowing. It would most likely end up in which of the following bronchopulmonary segments?
- Anterior segmental bronchus of right superior lobe
- Medial segmental bronchus of the right middle lobe
- Superior segmental bronchus of right inferior lobe
- Medial basal segmental bronchus of left inferior lobe
- Inferior segmental bronchus of lingular lobe
what is superior segmental bronchus of right inferior lobe?
300
Which of the following travels with the aorta through the aortic hiatus in the diaphragm?
Thoracic duct
Azygos vein
Right phrenic nerve
Vagus nerve
what is vagus nerve?
400
A patient has orbital cellulitis (infection in the orbit) that was caused by spread of bacteria from a paranasal sinus. Based on the anatomy of the sinuses, the bacteria most likely spread from the:
Ethmoid sinuses
Frontal sinus
Maxillary sinus
Sphenoid sinus
what is ethmoid sinuses?
400
If your patient had a lesion of the right oculomotor nerve, you would expect the right eye to be in which of the following positions?
what is D?
400
The structure that connects the middle ear with the nasopharynx is the:
Eustachian tube
External acoustic meatus
Internal acoustic meatus
Mastoid aditus
Petrotympanic fissure
what is eustachian tube?
400
Exploration of the tracheoesophageal groove at the level of the thyroid gland would reveal what is important structural bilaterally ?
Pyramidal lobe
Phrenic nerve
Cervical sympathetic trunk
Recurrent laryngeal nerve
what is recurrent laryngeal nerve?
400
The middle constrictor muscle arises from the:
Hamulus
Hyoid bone
Cricoid cartilage
Pterygomandibular raphe
Thyroid cartilage
what is hyoid bone?
400
You are called to perform thoracentesis (remove fluid from the pleural cavity). If you are to avoid injuring lung or neurovascular elements, where would you insert the aspiration needle?
- The top of interspace 8 in the midclavicular line
- The bottom of interspace 8 in the midclavicular line
- The top of interspace 9 in the midaxillary line
- The bottom of interspace 9 in the midaxillary line
- The top of interspace 11 in the scapular line
what is the bottom of interspace 9 in the midaxillary line?
400
A hand slipped behind the heart at its apex can be extended upwards until stopped by a line of pericardial reflection that forms the:
Cardiac notch
Costomediastinal recess
Hilar reflection
Oblique pericardial sinus
Transverse pericardial sinus
what is oblique pericardial sinus?
500
The septal artery that supplies the anterior part of the nasal septum is a branch of the:
Anterior ethmoid artery
Facial artery
Internal carotid artery
Maxillary artery
Sphenopalatine artery
what is facial artery?
500
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?
- Oculomotor nerve
- Optic nerve
- Facial nerve
- Ciliary ganglion
- Superior Cervical ganglion
what is oculomotor nerve?
500
Which of the following nerves contributes to the sensory innervation of the external ear?
Greater petrosal nerve
Maxillary nerve
Tympanic nerve
Vagus nerve
Zygomatic nerve
what is vagus nerve?
500
Which of the following is true of the inferior thyroid arteries?
They supply most of the anterior surface of the thyroid gland
They arise from the external carotid arteries
They cross over the superior cervical sympathetic ganglion
They often supply all four parathyroid glands
what is they often supply all four parathyroid glands
500
The pharyngeal tonsils (Adenoids) are associated with:
Laryngopharynx
Lateral walls of oral cavity
Nasopharynx
Oropharynx
Tongue
what is nasopharynx?
500
You are observing a doctor perform a bronchoscopy. As he passes the bronchoscope down the trachea, a cartilaginous structure is observed separating the tight and left main stem bronchi. He asks what it is called? You reply it really does look like a ship’s keel and it is called the:
Carina
Cricoid cartilage
Costal cartilage
Pulmonary ligament
Tracheal ring
what is carina?
500
In cardiac surgery it is sometimes necessary to clamp off all arterial flow out of the heart. This could be done within the pericardial sac by inserting the index finger immediately behind the two great arteries and compressing them with the thumb of the same hand. The index finger would have to be inserted into which space?
Cardiac notch
Coronary sinus
Oblique pericardial sinus
Coronary sinus
Transverse pericardial sinus
what is transverse pericardial sinus?
600
A 36-year-old man is admitted to the emergency department with a painful skin rash on the dorsum of his nose. Physical examination reveals that a herpetic lesion is affecting the dorsum of the nose and the eyeball. Which of the following nerves is most likely to be responsible for transmission of the virus to the eye?
Nasocillary
Supratrochlear
Infraorbital
Posterior ethmoidal
Anterior ethmoidal
what is nasocillary ?
600
Which of the following is the correct path for tears from the lacrimal gland to the nasal cavity?
A. lacrimal gland -> lacrimal sac -> lacrimal canaliculi -> nasolacrimal duct -> lacrimal puncta
B. lacrimal gland -> lacrimal sac -> lacrimal canaliculi -> lacrimal puncta -> nasolacrimal duct
C. lacrimal gland -> lacrimal canaliculi -> lacrimal puncta -> lacrimal sac -> nasolacrimal duct
D. lacrimal gland -> lacrimal puncta -> nasolacrimal duct -> lacrimal sac -> lacrimal canaliculi
E. lacrimal gland -> lacrimal puncta -> lacrimal canaliculi -> lacrimal sac -> nasolacrimal duct
what is E?
600
The central core of bone in the cochlea is the:
Ampulla
Modiolus
Scala tympani
Spiral lamina
Vestibule
what is modiolus?
600
After a mountain biking accident a young man is admitted to a hospital. Upon examination, he complains about pain in the neck and problems of mastication and swallowing. Further tests show a normal function of the larynx, but the mobility of the hyoid bone is limited. Trauma of which neck structure can result in paresis of the infrahyoid muscles?
Ansa cervicalis
Accessory nerve
Brachial plexus
Mandibular nerve
what is ansa cervicalis?
600
A stab wound of the neck compromises CN IX as it is passing between the superior and middle constrictors. You would expect to see:
Inability to elevate the soft palate
Inability to swallow
Loss of sensation in the laryngopharynx
Loss of sensation in the nasopharynx
Loss of sensation in the oropharynx
what is loss of sensation in the oropharynx?
600
The trachea which is located inferior to the larynx divides into left and right main bronchi at the level of what structure?
At the sternal angle (of Louis)
Body of the sternum (middle part)
Just above the xiphoid process
Just below the fourth rib
At the manubrium (superior part)
what is at the sternal angle (of Louis)?
600
A 55-year-old male patient presents with chest pain radiating to the left arm and shortness of breath. Which coronary artery is most commonly involved in cases of myocardial infarction?
A) Right coronary artery (RCA)
B) Left circumflex artery
C) Left anterior descending artery (LAD)
D) Posterior interventricular artery
what is left anterior descending artery (LAD) ?
700
A 24-year- old man is admitted to the hospital after the street fight. Radiographic examination reveals an inferior (blow-out) fracture on the orbit. Orbital structures would most likely be found inferiorly in which of the following spaces?
Ethmoidal sinus
Frontal sinus
Maxillary sinus
Nasal cavity
Sphenoidal sinus
what is maxillary sinus ?
700
An adolescent patient suffers from severe acne. As is often the case, they frequently squeezed the pimples on their face. They subsequently developed a fever and deteriorate into a confused mental state and drowsiness. They are taken to their physician, and after several tests, a diagnosis of cavernous sinus infection and thrombosis is made. The route of entry to the cavernous sinus from the face was most likely the:
- Carotid Artery
- Mastoid emissary vein
- Middle Meningeal Artery
- Ophthalmic Vein
- Parietal Emissary Vein
what is ophthalmic vein?
700
A 3-year-old child ruptured their eardrum when they inserted a pencil into their ear. Their parent took their child to the emergency department after noticing that the child was crying and complaining of pain in their ear with a few drops of blood in the external auditory meatus. The attending doctor examined the child for possible injury to a nerve that runs across the eardrum.
The most likely nerve to be injured is the:
Auricular branch of the vagus
Glossopharyngeal (CN IX)
Lesser Petrosal
Chorda Tympani
Trigeminal (CN V)
what is chorda tympani?
700
A 38-year-old man has had thyroid surgery to remove his papillary carcinoma. The external laryngeal nerve that accompanies the superior thyroid artery is damaged during the surgery. This injury could result in a severe impairment of function of which of the following?
Relaxing the vocal cords
Rotating the arytenoid cartilages
Tensing the vocal cords
Widening the rima glottidis
Abducting the vocal cords
what is tensing the vocal cords?
700
If your patient’s mandibular nerve (V3) was damaged, one symptom that you would expect is:
Loss of sensation in the laryngopharynx
Loss of sensation in the nasopharynx
Loss of sensation in the oropharynx
No loss of sensation in the pharynx
No loss of sensation anywhere in the head
what is no loss of sensation in the pharynx?
700
A 4 year old girl is brought in with severe chest pain, and you are told by her mother that she had been playing with some beads and had apparently aspirated one (gotten it into her airway). Where would you expect it to most likely be?
Apicoposterior segmental bronchus of left lung
Left main bronchus
Lingular segment of left lung
Right main bronchus
Right lung, lower lobe
what is right main bronchus?
700
A patient (50-year-old) with a heart valve (mitral) problem visits your dental office for periodontal therapy. She says that her previous periodontist always gave her antibiotics before the treatment and she insisted that the dentist hears the malfunctioning valve. She places the stethoscope in the right third intercostal space medial to the nipple line. Which space should she have placed the stethoscope to hear the heart valve problem?
Right second intercostal space
Right fifth intercostal space
Left fifth intercostal space
Left second intercostal space
Left sixth intercostal space
what is left fifth intercostal space?