1.
Which of the following statements is INCORRECT?
Correct Answer
A. All spinal nerves contain the same types of functional components
Explanation
The statement "All spinal nerves contain the same types of functional components" is incorrect because spinal nerves actually contain different types of functional components. Spinal nerves consist of both sensory and motor fibers. The sensory fibers transmit information from the body to the central nervous system, while the motor fibers transmit signals from the central nervous system to the muscles and glands. Therefore, this statement is incorrect as it suggests that all spinal nerves have the same types of functional components, which is not true.
2.
What nerve DOES the superior laryngeal artery accompany into the larynx?
Correct Answer
E. Internal laryngeal
Explanation
The superior laryngeal artery accompanies the internal laryngeal nerve into the larynx.
3.
Which of the following statements is NOT TRUE?
Correct Answer
C. The platysma muscle receives its motor supply from neurons derived from C2, C3 which are carried by the transverse cervical and greater auricular nerves
Explanation
The statement that is NOT TRUE is that the platysma muscle receives its motor supply from neurons derived from C2, C3 which are carried by the transverse cervical and greater auricular nerves.
4.
Regarding the parotid salivary gland, which of the following statements is INCORRECT?
Correct Answer
E. A lesion of the facial nerve at the stylomastoid foramen results in interruption of the nerve supply to the parotid and secretion is reduced
Explanation
The given statement is incorrect because a lesion of the facial nerve at the stylomastoid foramen does not result in reduced secretion of the parotid gland. The facial nerve is responsible for innervating the parotid gland and stimulating saliva production. If the nerve is interrupted at the stylomastoid foramen, it would result in paralysis of the muscles of facial expression, but it would not directly affect the secretion of the parotid gland.
5.
Select the TRUE statement regarding the neck:
Correct Answer
A. The axillary sheath that surrounds the brachial plexus is derived from the prevertebral fascia of the neck
Explanation
The axillary sheath that surrounds the brachial plexus is derived from the prevertebral fascia of the neck. This means that the fascia surrounding the brachial plexus originates from the fascia located in front of the vertebrae in the neck. This is important because the brachial plexus is a network of nerves that innervates the upper limb, and the axillary sheath provides protection and support to these nerves. Understanding the origin and structure of the axillary sheath is essential for understanding the anatomy and function of the brachial plexus.
6.
Select the INCORRECT statement regarding the facial blood vessels
Correct Answer
C. The facial vein most commonly drains into the external jugular vein
Explanation
The correct answer is that the facial vein most commonly drains into the external jugular vein. This means that the facial vein does not typically drain into the external jugular vein, which is an incorrect statement. The facial vein actually drains into the internal jugular vein.
7.
The skin of the face receives its sensory supply primarily from branches of
Correct Answer
E. The trigeminal nerve
Explanation
The trigeminal nerve is responsible for providing sensory supply to the skin of the face. It has three main branches: the ophthalmic nerve, the maxillary nerve, and the mandibular nerve. These branches innervate different regions of the face, including the forehead, cheeks, and jaw. Therefore, the trigeminal nerve is the correct answer for this question.
8.
Damage to the facial nerve at the stylomastoid foramen would MOST LIKELY cause
Correct Answer
D. Inability to smile symmetrically
Explanation
Damage to the facial nerve at the stylomastoid foramen would most likely cause an inability to smile symmetrically. The facial nerve controls the muscles of facial expression, including the muscles involved in smiling. Damage to the nerve can result in weakness or paralysis of these muscles, leading to an asymmetrical smile.
9.
A 38‑year‑old diabetic female is diagnosed with right‑sided Bell's palsy, the result of injury to the facial nerve. Which of the following is MOST LIKELY to be seen in a patient with Bell's palsy?
Correct Answer
B. Inability to blink the right eye
Explanation
Inability to blink the right eye is most likely to be seen in a patient with Bell's palsy. Bell's palsy is a condition that causes sudden weakness or paralysis of the muscles on one side of the face, including the muscles that control blinking. This can result in the inability to close the affected eye properly, leading to dryness, irritation, and potential damage to the cornea.
10.
A 16‑year‑old high school student with a bad case of acne complains of severe headache, high fever and problems with eye movements. Apparently, an infection had spread from a pimple on his face into the cavernous sinuses within his cranium through the:
Correct Answer
B. Facial and superior opHthalmic veins
Explanation
The facial and superior ophthalmic veins are the correct answer because they provide a pathway for the infection to spread from the pimple on the face into the cavernous sinuses within the cranium. These veins connect the face and the eyes to the cavernous sinuses, allowing the infection to travel through them and cause the severe headache, high fever, and problems with eye movements that the patient is experiencing.
11.
A 60‑year‑old woman presents with tic douloureux which is characterized by excruciating facial pain over the distribution of the fifth cranial nerve. This involves sensory neurons whose cell bodies are located in the:
Correct Answer
B. Trigeminal ganglion
Explanation
The correct answer is the trigeminal ganglion. Tic douloureux, also known as trigeminal neuralgia, is a condition characterized by severe facial pain along the distribution of the fifth cranial nerve (trigeminal nerve). The trigeminal ganglion is a sensory ganglion that contains the cell bodies of the sensory neurons responsible for transmitting sensory information from the face to the brain. Therefore, it is the most likely location for the cell bodies of the affected neurons in this patient.
12.
A 45‑year‑old man presented to his physician with facial paralysis and increased sensitivity to sound. Examination revealed a lesion of the facial nerve in the facial canal. This lesion is also LIKELY to result in:
Correct Answer
B. Loss of taste from anterior two thirds of tongue
Explanation
The facial nerve is responsible for innervating the taste buds on the anterior two thirds of the tongue. Therefore, a lesion in the facial nerve, as described in the case, would likely result in a loss of taste from the affected area of the tongue.
13.
An 11‑year‑old boy who fell off his bike was taken to the pediatrician after developing a black eye. X‑ray reveals that he has an epicranial hematoma which is located:
Correct Answer
B. In the fourth or loose connective tissue layer of the scalp
Explanation
The correct answer is "In the fourth or loose connective tissue layer of the scalp." An epicranial hematoma is a collection of blood that forms between the scalp and the skull. The scalp has five layers, and the fourth layer is known as the loose connective tissue layer. This is where the hematoma would be located in this case.
14.
The patient was brought to the emergency room coughing violently, and complaining that she had a bug in her ear. On examination, a large, common household insect was found lodged in her ear. After forceps removal of the creature and bathing of the external ear canal, together with the administration of a sedative, the patient's violent coughing ceased. The nerve fibers carrying the sensory input from the ear canal irritation, AND the nucleus or ganglion containing the motor neurons responsible for the spasmodic contraction of pharyngeal and laryngeal musculature were the ...
Correct Answer
A. Auricular branches of the vagus and the nucleus ambiguus
Explanation
The auricular branches of the vagus nerve carry sensory input from the ear canal irritation, while the nucleus ambiguus contains the motor neurons responsible for the spasmodic contraction of pharyngeal and laryngeal musculature. Therefore, the auricular branches of the vagus and the nucleus ambiguus are the correct answer as they are involved in both the sensory input from the ear canal irritation and the motor response of coughing.
15.
The 4th semester student was performing a physical examination of a 19‑year‑old female patient from Portsmouth who was troubled by a problem with cranial nerve dysfunction. The student first asked the patient to turn her head to the left, and look to the left. She‑then gently touched the limbus of the patient's right eye with a little bit of cotton. As she touched the eye, she observed that the patient's right eye blinked, but the left one didn't. She then repeated the procedure, having the young woman turn her head and her eyes to the right, while the student stroked the left limbus. Now, she noted that the right eye blinked, but the left one did not. She correctly deduced from her observations that ...
Correct Answer
B. The patient exhibited paralysis of the left facial nerve
Explanation
Based on the student's observations, when the right eye was touched, it blinked indicating a normal response. However, when the left eye was touched, it did not blink, suggesting a lack of response. This indicates that there is a dysfunction in the left facial nerve, leading to the conclusion that the patient exhibited paralysis of the left facial nerve.
16.
The trochlear and oculomotor nerves can be affected directly by aneurysms of either of two arteries as the nerves leave the brainstem, for both nerves pass between the two arteries. One of these two arteries contributes directly to the "arterial circle of Willis"; the other does not. The artery that contributes to the "Circle" and which can affect either of the two nerves is the ...
Correct Answer
B. Posterior cerebral
Explanation
The posterior cerebral artery contributes directly to the "arterial circle of Willis" and can affect either the trochlear or oculomotor nerves. As the nerves leave the brainstem, they pass between two arteries, and aneurysms of either of these arteries can directly affect the nerves. The other arteries mentioned in the options do not contribute to the "Circle" or have a direct impact on the trochlear and oculomotor nerves. Therefore, the correct answer is the posterior cerebral artery.
17.
Several attempts had been made to stop the bleeding from Kiesselbach's area of the patient's nose, including application of silver nitrate and cauterization. At times, she was in danger of fatal aspiration of blood. The bleeding was stopped finally by a combination of anterior and posterior nosepacks. Epistaxis (nosebleed) can be an important source of loss of blood, when it cannot be stopped. This is due in large part to the number of arteries that supply the area of the nasal septum. Arteries which provide branches to the anterior inferior part of the nasal septum include the ...
Correct Answer
A. Branches of the spHenopalatine artery and a branch derived from the facial artery
Explanation
Epistaxis, or nosebleed, can be difficult to stop due to the numerous arteries that supply the nasal septum. In this case, the bleeding was finally stopped by using a combination of anterior and posterior nosepacks. The arteries that provide branches to the anterior inferior part of the nasal septum include branches of the sphenopalatine artery and a branch derived from the facial artery. These arteries are likely responsible for the persistent bleeding and were effectively addressed by the nosepacks.
18.
A 7‑year‑old girl is brought into your pediatric clinic coughing, and with extreme pain in her throat. She had been playing dressup with her dolls and swallowed an open, small safety pin, which had lodged somewhere in her throat. With a laryngoscope, the pin is seen in the laryngopharynx, inferior and lateral to the right aryepiglottic fold. The probable location of the pin, and the nerve conveying the sense of pain, are ...
Correct Answer
A. Piriform recess; pain conveyed by the internal laryngeal nerve
Explanation
The probable location of the pin is in the piriform recess, which is inferior and lateral to the right aryepiglottic fold. The pain from the pin is likely conveyed by the internal laryngeal nerve, which innervates the laryngopharynx.
19.
The fascia of the neck are important in spread of infections, blood, anesthetic agents and also in operative approaches. Among the characteristics of the superficial investing fascia is that it ...
Correct Answer
E. Ensheathes (surrounds) and passes between the trapezius and the sternocleidomastoid muscles
Explanation
The correct answer is that the superficial investing fascia of the neck ensheathes (surrounds) and passes between the trapezius and the sternocleidomastoid muscles. This means that it forms a sheath or covering around these muscles and also passes between them. This characteristic is important to note because it helps to understand the anatomical relationship and location of the fascia in the neck.
20.
A 14‑year‑old male with severe acne is brought into your office with a painful inflammation of the right side of his face, below the eye. He is feverish and complains of headache. Laboratory tests reveal elevated white cell counts in serum and cerebrospinal fluid, indicative of spread of bacterial infection into the intracranial space. The anatomical route through which the infection spread is MOST LIKELY the ...
Correct Answer
D. Angular vein to opHthalmic vein to cavernous sinus (or, anterior intercavernous sinus)
Explanation
The infection in the right side of the face, below the eye, has spread to the intracranial space, causing inflammation and symptoms such as fever and headache. The anatomical route through which the infection most likely spread is the angular vein to the ophthalmic vein to the cavernous sinus (or, anterior intercavernous sinus). The angular vein connects to the ophthalmic vein, which then drains into the cavernous sinus. This route allows for the infection to spread from the facial area to the intracranial space.
21.
At your rural clinic a five‑year‑old girl is brought in by her parents because she has a "wry neck." Physical examination reveals no increased tone in neck muscles and all cranial nerve tests are normal. Her history reveals a difficult breech ("feetfirst") birth, however, during which excessive traction was put on her head and neck. You diagnose Congenital Torticollis. Damage to what structure(s) accounts for this condition?
Correct Answer
B. Sternocleidomastoid muscle
Explanation
Excessive traction during a difficult breech birth can cause damage to the sternocleidomastoid muscle, leading to Congenital Torticollis. This condition is characterized by a "wry neck," where the head is tilted to one side and the chin is rotated to the opposite side. The sternocleidomastoid muscle plays a significant role in head and neck movements, and damage to this muscle can result in the abnormal positioning of the head and neck seen in Congenital Torticollis.