Block 5 Anat Head Neck Mini Quest Prt 2

20 Questions | Total Attempts: 66

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Block 5 Anat Head Neck Mini Quest Prt 2

Questions and Answers
  • 1. 
    The prominent US political leader remembered that he had hit his head on a low‑ hanging branch of a tree while riding horseback, although he had not fallen from the saddle. The confusion and memory problems he was experiencing recently resulted in cranial examination with magnetic resonance and CT imaging. A subdural hematoma was diagnosed. Such an injury resulted from injury to ...
    • A. 

      The anterior communicating artery

    • B. 

      Middle meningeal artery

    • C. 

      Inferior petrosal venous sinus

    • D. 

      A parietal emissary vein, passing into the diploe from the scalp

    • E. 

      A cerebral vein

  • 2. 
    The patient required excision of a mass in the floor of his mouth. Unfortunately the extent of the tumor resulted in post­operative problems with function of the tongue. When he was asked to protrude ("stick out") his tongue, it pointed to the patient's right; he could not point it straight ahead, nor to the left. The structure that has been paralyzed is the ...
    • A. 

      Right vagus nerve

    • B. 

      Left hyoglossus muscle

    • C. 

      The left hypoglossal nerve

    • D. 

      The right genioglossus muscle

    • E. 

      The left lingual nerve

  • 3. 
    The 35‑year‑old man presented with aching pain in his right upper teeth and a sensation of fullness and pulsation in his right cheek. Examinations reveal pus in his right middle nasal meatus. These symptoms are MOST suggestive of ...
    • A. 

      Superior ethmoidal sinusitis

    • B. 

      Maxillary sinusitis

    • C. 

      Inflammation of the nasolacrimal duct

    • D. 

      Sphenoidal sinusitis

    • E. 

      Frontonasal sinusitis

  • 4. 
    Which of the following events might be expected with laceration (cutting or tearing) of the middle meningeal artery at the region of the pterion?
    • A. 

      Interruption of arterial blood supply to the frontal lobe of the brain on the affected side

    • B. 

      Epidural hematoma, increased intracranial pressure

    • C. 

      Detection of blood in the cerebrospinal fluid

    • D. 

      Subdural hematoma, associated with herniation of the brainstem

    • E. 

      Subarachnoid hemorrhage and spasm of cerebral arteries, followed by ischemia

  • 5. 
    One of the hazards in thyroid surgery is the possibility of injury to the recurrent laryngeal nerves, with resulting paralysis of the muscles that open the airway, separating the vocal cords. The muscles which perform this function are the ...
    • A. 

      Posterior cricoarytenoids

    • B. 

      Cricothyroids

    • C. 

      Transverse and oblique fibers of the arytenoideus

    • D. 

      Lateral cricoarytenoids

    • E. 

      Thyroarytenoids

  • 6. 
    A child is presented by his mother in the morning clinic. The young boy has a unilateral cleft lip, and the mother asks you for your advice on the proper course of corrective treatment. With your excellent grasp of embryology, you first remember that this defect results usually from a...
    • A. 

      Failure of fusion of the mandibular prominences

    • B. 

      Failure of fusion of the medial nasal swelling with the maxillary process

    • C. 

      Persistence of the nasolacrimal groove

    • D. 

      Failure of fusion of the lateral nasal swellings

    • E. 

      Failure of fusion of the maxillary shelves (swellings) with each other

  • 7. 
    Intralaryngeal structures are involved frequently in traumatic injuries, stress from overuse, infectious processes and other pathology. Which of the following statements is TRUE regarding laryngeal anatomy?
    • A. 

      The space beneath the true vocal cord or ligament is drained by specific lymphatic vessels which drain directly to the prelaryngeal node (Delphian node) or to the juguloomohyoid nodes, bilaterally.

    • B. 

      The rima glottidis is the space between the true vocal folds and the false vocal folds.

    • C. 

      Sensory supply to the interior of the larynx from true vocal folds to vestibule is provided by the recurrent laryngeal nerves.

    • D. 

      The glottis consists of the rima glottidis and the true vocal folds.

    • E. 

      The vocal process of the corniculate cartilage provides attachment for the true vocal ligament.

  • 8. 
    During the course of a total physical examination in the Geriatrics division of the hospital, including Magnetic Resonance Imaging, the images provided evidence ‑ of the presence of a small (2.0 cm) tumor which involved several nerves in the cranial cavity of the 67‑year‑old male patient. His right shoulder drooped, in comparison with the left shoulder. He could not abduct the right arm above 90 degrees. He had difficulty swallowing. He had weakness turning his head to the left. On oral exam, his uvula pointed to the left, and sensitivity of his pharynx to stimuli was reduced. Lesions of which combination of nerves would BEST explain the signs?  
    • A. 

      Right vagus, right spinal accessory, right glossopharyngeal

    • B. 

      Left vagus, left spinal accessory, right glossopharyngeal

    • C. 

      Right mandibular (V3), left glossopharyngeal, left superior laryngeal

    • D. 

      Right recurrent laryngeal, right spinal accessory, right hypoglossal

    • E. 

      Left recurrent laryngeal, left spinal accessory, left pharyngeal branch of vagus

  • 9. 
    A 71‑year‑old woman is brought to the hospital complaining of difficulty in breathing. The attending physician decides that she should be given an emergency tracheostomy, but when the midline incision is made through the skin below the thyroid cartilage, profuse bleeding occurs. After tying off the bleeding vessel and inserting the tracheal tube, the physician then remembers (too late) that in some 10% of individuals a variable artery lying in the midline below the thyroid gland can be damaged during tracheostomy. The vessel can arise from the aortic arch, the vertebral artery, or the common carotid artery. This vessel is the
    • A. 

      Ascending cervical artery

    • B. 

      Middle thyroid artery

    • C. 

      Ascending pharyngeal artery

    • D. 

      Thyroid ima artery

    • E. 

      Superior laryngeal artery

  • 10. 
    The young patient was to undergo a tonsillectomy for removal of the palatine tonsils. The pediatric surgeon, performing this procedure by himself for the first time, reviewed the anatomy of this area. He should remember ....
    • A. 

      The palatine tonsil is found within the oropharynx

    • B. 

      The glossopharyngeal nerve passes deep to the lymphoid tissue of the tonsillar fossa.

    • C. 

      The principal source of arterial supply to the palatine tonsil arises from the facial artery.

    • D. 

      The lymphoid tissue to be removed lies just behind the structure that forms the anterior pillar of the fauces.

    • E. 

      All of the statements listed in the choices of this question are true.

  • 11. 
    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?
    • A. 

      Ansa cervicalis

    • B. 

      Sternocleidomastoid muscle

    • C. 

      Posterior scalene muscle

    • D. 

      Ligamentum nuchae

    • E. 

      Anterior scalene muscles

  • 12. 
    The 25‑year‑old, 3rd semester medical student was hit in the left eye by the football, which had just been thrown with great force by the former professional quarterback on the opposite team. The football lacerated the upper eyelid, which was closed at the time of impact, compressing the eyeball with force. On examination, you discover a severe hematoma (bruise) of the upper lid, and echymoses (broken blood vessels) in the lateral portion of the sclera of the eye. The iris of the left eye appears sunken in comparison to the right. When you test extraocular eye function, the patient cannot look up with the left eye when it is abducted, or look up when the left eye is adducted. What is the MOST LIKELY diagnosis?
    • A. 

      Direct damage to the inferior division of CN III and CN IV

    • B. 

      Blow cut fracture and entrapment of inferior rectus and inferior oblique muscles

    • C. 

      Direct damage to the superior division of CN III and CN VI

    • D. 

      Fracture to the greater wing of the sphenoid bone and lateral orbital wall and entrapment of lateral rectus and inferior oblique muscles

    • E. 

      Direct damage to the zygomaticofacial branch of CN VII and ophthalmic division of CN V

  • 13. 
    The cranial nerve that would be affected FIRST in cavernous sinus thrombosis, due to the passage of the nerve through the sinus, separated from its contents only by a thin layer of endothelium, is the ...
    • A. 

      Ophthalmic nerve

    • B. 

      Maxillary nerve

    • C. 

      Mandibular nerve

    • D. 

      Abducens nerve

    • E. 

      Optic nerve

  • 14. 
    The 2‑year‑old child suffered major congenital problems of the first branchial (pharyngeal) arch. Structures that would MOST READILY be affected in such a case would be the ...
    • A. 

      Malleus and incus

    • B. 

      Stapedius muscle

    • C. 

      Stylopharyngeus muscle

    • D. 

      Vagus nerve

    • E. 

      Stylohyoid ligament

  • 15. 
    The eighth grade boy was observed in the clinic because of a midline, fluid‑filled swelling just below the center of the hyoid bone. After palpating the soft mass, and suspecting its origin, you ask the boy to stick out his tongue. When he does this, you observe that the cervical mass also moves. It also moves when he swallows. This confirms your diagnosis that the lad has...
    • A. 

      An internal branchial cyst

    • B. 

      A cervical branchial cyst

    • C. 

      A pharyngeal fistula

    • D. 

      Aberrant thymic tissue

    • E. 

      A thyroglossal duct cyst

  • 16. 
    In checking the integrity of the cranial nerves, the examiner will typically check the major actions of the muscles of mastication. Which of the following muscles is of major importance both in opening the mouth and for protruding the jaw?  
    • A. 

      Temporalis

    • B. 

      Masseter

    • C. 

      Lateral pterygoid

    • D. 

      Medial pterygoid

    • E. 

      Buccinator

  • 17. 
    A tumor that invades the jugular canal is MOST LIKELY to result in
    • A. 

      Hyperacusis

    • B. 

      Hoarseness

    • C. 

      Deafness

    • D. 

      A paralyzed and atrophied tongue

    • E. 

      Loss of voluntary closure of the eyelids

  • 18. 
    In the performance of the physical examination of the patient after the automobile accident, in which the woman had hit her forehead against the dashboard of the vehicle, you observe that her right pupil cannot be turned medially and downward. [She can adduct the affected eye medially toward the nose, but she cannot direct the pupil downward from that position.] She has no difficulty looking upward or laterally. If she first gazes laterally with the affected eye, she can look downward with it. It is probable from these signs that she has a nerve lesion or paralysis of the ...
    • A. 

      Right abducens nerve

    • B. 

      Right inferior rectus muscle

    • C. 

      Right inferior oblique muscle

    • D. 

      Right oculomotor nerve

    • E. 

      Right trochlear nerve

  • 19. 
    A four year old girl, Cherylee, was brought to your office because of frequently occurring colds and sore throat. Her mother told you that Cherylee was sick far more often than her two older brothers and her younger sister. When you asked the mother if the child had ever had any other problems, she mentioned that when Cherylee was born she had a connection between her "heart artery" and her "lung artery," and you realized that she was referring to the presence of a patent ductus arteriosus in the newly born baby. With this information, plus other evidence that Cherylee seems to be immunologically compromised, you correctly deduce that the child ...
    • A. 

      Has the characteristics of Treacher Collins syndrome

    • B. 

      Is suffering from malar hypoplasia

    • C. 

      Possesses the Robin sequence, with resultant severe defects of the first arch

    • D. 

      Has abnormal development of the 1st pharyngeal pouch

    • E. 

      Suffers abnormal development of 3rd and 4th pharyngeal pouch derivatives

  • 20. 
    Two weeks following a thyroidectomy, a 45‑year‑old opera singer complains that she has difficulty in changing the tone of her voice. You examine her larynx with a laryngoscope and note that while the arytenoid cartilages move normally, the thyroid cartilage does not tilt forward when you ask her to change the tone of her voice. Clearly there has been damage to a nerve. With which artery DOES the damaged nerve run?
    • A. 

      Internal laryngeal artery

    • B. 

      Inferior thyroid artery

    • C. 

      Superior laryngeal artery

    • D. 

      Inferior laryngeal artery

    • E. 

      Superior thyroid artery

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