Show:
Cranial Nerves
Nerve Pathways
Arterial Supply
Temporal and Infratemporal Fossa
Neck Triangles
100

Voluntary opening of the upper eyelid is produced by the motor innervation of what nerve?

  1. Trochlear nerve

  2. Oculomotor nerve 

  3. Abducens nerve

  4. Facial nerve

  5. Trigeminal nerve

B. Oculomotor Nerve

  • Motor, movement of eye

  • Foramen: superior orbital fissure (sphenoid bone)

  • Muscles:

    • Levator Palpebrae superioris

    • Superior rectus

    • Medial rectus

    • Inferior rectus

    • Inferior oblique

100

What nerve supplies sensation to the skin of the cheek, upper lip, and lower eyelid.

Infraorbital Nerve


100

The subclavian artery and subclavian vein are usually separated in the posterior triangle of the neck by what structure?

  1. The first rib

  2. One belly of the omohyoid muscle

  3. Anterior scalene muscle

  4. Clavicle

  5. Vagus Nerve

C. Anterior scalene muscle


100

You are removing the brain from your cadaver to help prepare for neuroanatomy next block. As Dr. Solounias takes the bone saw, he asks you which layer of the scalp connects the occipitalis muscle with the frontalis muscle. You respond with…

  1. “The skin”

  2. “The aponeurosis”

  3. “The pericranium”

  4. “The occipitalis muscle”

  5. “The loose connective tissue”

  6. “The connective tissue”

  7. “The frontalis muscle"

  • B! The aponeurosis

    • Recall the mnemonic: SCALP

      • Lists the levels of the scalp from superficial to deep:

        • Skin

        • Connective tissue (contains nerves and vessels)

        • Aponeurosis (connects frontalis to occipitalis)

        • Loose connective tissue (lets scalp move over skull)

        • Pericranium (periosteum of cranial bones

 


100

The subclavian artery and subclavian vein are usually separated in the posterior triangle of the neck by what structure?

  1. The first rib

  2. One belly of the omohyoid muscle

  3. Anterior scalene muscle

  4. Clavicle

  5. Vagus Nerve

3. Anterior Scalene Muscle


200

A 23-year-old male is hospitalized and undergoing treatment to resolve a clot and infection in the cavernous sinus. You are evaluating the patient and discover he is unable to abduct his right eye. What structure is most likely affected?

  1. Abducens nerve 

  2. Lateral rectus muscle 

  3. Trochlear nerve 

  4. Superior oblique muscle 

  5. Medial rectus muscle

A. Abducens Nerve


200

What nerve carries taste from the anterior two-thirds of the tongue. (Hint: It is a branch of the facial nerve)

Chorda Typmani 


200

Muscles innervated by the hypoglossal nerve receive a larger portion of their arterial blood supply from the branches of the:

  1. Internal carotid artery

  2. Facial artery

  3. Maxillary Artery

  4. Superior Thyroid Artery

  5. Lingual Artery

E. Lingual Artery

  1. Think about what muscles the hypoglossal nerve innervates: tongue muscles!!

  2. Think about what is the likely artery in the mouth: Lingual! ”lingual” means tongue

200

The roots of the brachial plexus pass through which triangle with which part of the subclavian artery?

  1. Carotid triangle; 1st part

  2. Interscalene triangle; 2nd part

  3. Posterior triangle; 2nd part

  4. Interscalene triangle; 3rd part

  5. Carotid triangle; 2nd part

  6. Anterior muscular triangle; 2nd part

  • D! Interscalene triangle; 3rd part

    • This is an important clinical correlate for thoracic outlet syndrome (though not super important for you now)

  • All other triangles are not really associated with the subclavian artery

200

Which of the following can be found in the posterior triangle of the neck?

  1. Omohyoid muscle

  2. Posterior belly of the digastric muscle

  3. CN XII

  4. CN XI

  5. Anterior jugular vein

D. CN XI


300

The maxillary division of the trigeminal nerve (CN V2) exits the skull through this foramen.

Foramen Rotundum 

Branches:

Infraorbital

zygomaticotemporal 

zygomaticofacial

300

What nerve provides sensory innervation to the temporal region and helps carry parasympathetic fibers to the parotid gland.

Auriculotemporal Nerve

300

What spinal level does the common carotid artery bifurcate?

  1. C1

  2. C2

  3. C3

  4. C4

  5. C5

4. C4

Does the internal carotid artery have any extra-cranial branching?

NO!! Look at which artery has a ton of the branches coming off of it and you found the external carotid artery. The internal carotid artery doesn’t branch until its inside the cranium


300

What vein does the retromandibular vein receive blood from and where does it directly drain into?

  1. Maxillary vein; internal jugular vein

  2. Superficial temporal vein; anterior jugular vein

  3. Superficial temporal vein; internal jugular vein

  4. Maxillary vein; external jugular vein

  5. Infraorbital vein, anterior jugular vein

  6. Supraorbital vein, external jugular vein

  • D! Maxillary vein; External jugular vein

    • The maxillary vein and superficial temporal vein both drain into the maxillary vein

    • The maxillary vein and the posterior auricular vein then drain into the external jugular vein



300

The facial nerve innervates which 2 muscles? (choose 2)

  1. Digastric (anterior belly)

  2. Stylopharyngeus

  3. Stapedius

  4. Digastric (posterior belly)

  5. Stylohyoid

D. Digastric (posterior belly)

E. Stylohyoid

Facial Nerve (CNVII) exits the stylomastoid foramen. It makes sense that the stylohyoid and posterior belly of digastric are innervated by it.


400

A small growth or tumor in the jugular foramen may affect which nerves?

  1. Hypoglossal and vagus

  2. Vagus, glossopharyngeal, hypoglossal

  3. Facial, glossopharyngeal, vagus

  4. Vestibulocochlear, glossopharyngeal, vagus

  5. Glossopharyngeal, vagus, spinal accessory

5. Glossopharyngeal, vagus, spinal accessory 



400

You have stumbled into a dental rotation and are required to place a nerve block to operate on a patient’s lower teeth. The nerve enters the mandible at which point?

  1. Mental foramen

  2. Mandibular foramen

  3. Temporal fossa

  4. Infraorbital foramen

  5. Stylomastoid foramen

  6. Foramen ovale

  7. Foramen spinosum

  • B! Mandibular foramen

    • The nerve in question is the inferior alveolar nerve, which innervates the lower teeth

400

Any manipulation of the superior thyroid artery must be undertaken with care to not damage what small companion nerve?

  1. Cervical sympathetic trunk

  2. External branch of superior laryngeal nerve

  3. Inferior root of ansa cervicalis

  4. Internal branch of superior laryngeal nerve

  5. Recurrent laryngeal nerve

2. External branch of superior laryngeal nerve


400

Question 6: You have stumbled into a dental rotation and are required to place a nerve block to operate on a patient’s lower teeth. The nerve enters the mandible at which point?

  1. Mental foramen

  2. Mandibular foramen

  3. Temporal fossa

  4. Infraorbital foramen

  5. Stylomastoid foramen

  6. Foramen ovale

  7. Foramen spinosum

  • B! Mandibular foramen

  • The nerve in question is the inferior alveolar nerve, which innervates the lower teeth

  • The mental foramen is where the mental nerve exits the mandible

  • The temporal fossa is a groove where the temporalis muscle resides

  • The infraorbital foramen is where the infraorbital nerve exits

  • The stylomastoid foramen is where CN VII exits the skull

  • Foramen ovale is where CN V3 exits the skull

  • Foramen spinosum is where the middle meningeal artery enters the skull

400

During a carotid endarterectomy, a mistake occurs which causes a blockage in the external carotid artery. However, the thyroid can still receive blood from which artery?

  1. Superior thyroid artery via thyrocervical trunk

  2. Inferior thyroid artery via thyrocervical trunk

  3. Inferior thyroid artery via costocervical trunk

  4. Superior thyroid artery via costocervical trunk

  5. Middle thyroid artery via costocervical trunk

  6. Middle thyroid artery via thyrocervical trunk

  • B! Inferior thyroid artery via thyrocervical trunk

  • The thyrocervial trunk branches off of the subclavian artery, and one of the branches, the inferior thyroid artery, will supply the thyroid

    • Other branches of the thyrocervical include the transverse cervical artery and the suprascapular artery

  • The superior thyroid artery branches off of the external carotid artery

  • The costocervical trunk branches off of the 2nd part of the subclavian

  • There is no middle thyroid artery, only a middle thyroid vein
500

Name the terminal branches of the facial nerve (CN VII)

Temporal/Zygomatic/Buccal/Marginal Mandibular/Cervical 

mnemonic: To Zanzibar By Motor Car 


500

Which of these structures are part of the sphenoid bone? Select all that apply:

  1. Foramen ovale

  2. Foramen spinosum

  3. Supraorbital notch

  4. Lateral pterygoid plate

  5. Infraorbital foramen

  6. Mental foramen

  • Foramen ovale, foramen spinosum, and the lateral pterygoid plate

    • Foramen ovale: where CN V3 exits

    • Foramen spinosum: where the middle meningeal artery enters the skull

    • Lateral pterygoid plate: where the lateral pterygoid attaches

500

A 16-year-old male is brought in by emergency medical services to the emergency department after being involved in a head-on collision. He is currently awake and alert, and responds to questions and commands. However, a CT scan of the head shows a collection of blood in the epidural space. The most likely source of this blood is a(n):

  1. Rupture of the bridging veins

  2. Tear of the middle meningeal artery

  3. Rupture of a berry aneurysm

  4. Embolus to the left posterior cerebral artery

  5. Rupture of a Charcot-Bouchard microaneurysm

B. Tear of the middle meningeal artery


500

You are having a bad day and hear a friend say “It takes more muscles to frown than to smile.” Rightfully irritated by this cliché, you challenge them to name the muscles for frowning and smiling. Which muscles are not involved with smiling or frowning?

  1. Orbicularis oculi

  2. Orbicularis oris

  3. Levator labii superioris

  4. Depressor anguli oris

  5. Buccinator

  6. Zygomaticus major

  7. Depressor labii inferioris

  8. Levator anguli oris

  • A, B, and E! Orbicularis oculi, orbicularis oris, and buccinator

    • Orbicularis oculis is the sphincter of the eye

    • Orbicularis oris is the sphincter of the mouth

    • Buccinator assists in eating

  • Levator labii superioris, levator anguli oris, and zygomaticus major all assist in lifting the lips superiorly

  • Depressor labii inferioris and depressor anguli oris pull the lips down

  • All listed muscles are innervated by CN VII


500

What are the muscles of the anterior triangle?


Thyrohyoid, Omohyoid, Sternohyoid, and Sternothyroid 

mnemonic: TOSS