Block 5 Anat Head Neck Mini Quest Prt 3
- 1.
After a tonsillectomy a 14‑year‑old female patient has persistent bleeding from the tonsillar bed. Blood flow is slow but constant. The source of the blood is MOST LIKELY the:
- A.
Superior thyroid vein
- B.
Tonsillar branch of the facial artery
- C.
External palatine vein
- D.
Ascending palatine artery
- E.
Ascending pharyngeal artery
Correct Answer
C. External palatine veinExplanation
The external palatine vein is the most likely source of persistent bleeding from the tonsillar bed after a tonsillectomy. The tonsillar bed is a highly vascular area, and the external palatine vein is one of the major veins in this region. It receives blood from the tonsillar branches of the facial artery, which supply the tonsils with oxygenated blood. Therefore, if there is persistent bleeding, it is likely that the external palatine vein has been damaged or not properly cauterized during the tonsillectomy procedure.Rate this question:
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- 2.
An 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 observed that the cervical mass also moves. It also moves when he swallows. This confirms your diagnosis that the lad has:
- A.
A cervical branchial cyst
- B.
A pharyngeal fistula
- C.
Aberzant thymic tissue
- D.
An internal branchial cyst
- E.
A thyroglossal duct cyst
Correct Answer
E. A thyroglossal duct cystExplanation
The observation of the cervical mass moving when the boy sticks out his tongue and swallows suggests that the swelling is connected to the tongue and is moving along with it. This is a characteristic feature of a thyroglossal duct cyst. The thyroglossal duct is a structure that forms during embryonic development and usually disappears before birth. However, in some cases, it may persist and form a cyst. This cyst can present as a midline, fluid-filled swelling below the hyoid bone. The movement of the cyst with tongue protrusion and swallowing confirms the diagnosis of a thyroglossal duct cyst.Rate this question:
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- 3.
A 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.
Inflammation of the nasolacrimal duct
- B.
Sphenoidal sinusitis
- C.
Superior ethmoidal sinusitis
- D.
Maxillary sinusitis
- E.
Frontonasal sinusitis
Correct Answer
D. Maxillary sinusitisExplanation
The patient's symptoms of aching pain in the upper teeth, fullness, and pulsation in the right cheek, along with the presence of pus in the right middle nasal meatus, are most suggestive of maxillary sinusitis. The maxillary sinuses are located in the cheek area, and inflammation or infection in these sinuses can cause pain and pressure in the surrounding areas. The presence of pus in the nasal meatus further supports the diagnosis of maxillary sinusitis.Rate this question:
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- 4.
Which of the following statements is INCORRECT:
- A.
Fracture of cribriform plate may give CSF leakage from nose
- B.
Battles sign is indicative of basilar skull fracture
- C.
On X ray, skull sutures have straight dark edges
- D.
Pterion important landmark for middle meningeal artery
- E.
Otitis media can lead to mastoiditis
Correct Answer
C. On X ray, skull sutures have straight dark edgesExplanation
Skull sutures are not visible on X-ray as they are not made of bone. They are fibrous joints between the bones of the skull and are not visible on X-ray images. Therefore, the statement that "On X-ray, skull sutures have straight dark edges" is incorrect.Rate this question:
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- 5.
A 16‑year‑old teenager presents to the doctor with high fever, severe headache, and a pus‑filled pimple on the upper lip. An infection from the superficial face, (danger zone of the face), had MOST LIKELY spread from the facial vein into the cavernous sinus within the cranial cavity via the:
- A.
Superior ophthalmic vein
- B.
Diploic vein
- C.
Retromandibular vein
- D.
Maxillary vein
- E.
Internal jugular vein
Correct Answer
A. Superior ophthalmic veinExplanation
The correct answer is the Superior ophthalmic vein. Infections in the danger zone of the face can spread to the cavernous sinus through the ophthalmic veins. The ophthalmic veins are located in close proximity to the upper lip and drain blood from the face, including the area of infection. The infection can then travel through the superior ophthalmic vein to reach the cavernous sinus within the cranial cavity. This can lead to severe complications due to the proximity of the cavernous sinus to important structures in the brain.Rate this question:
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- 6.
What nerve DOES the superior laryngeal artery accompany into the larynx?
- A.
Recurrent laryngeal
- B.
Vagus
- C.
Descendens hypoglossal of ansa cervicalis
- D.
The nerve to the cricothyroid muscle
- E.
Internal laryngeal
Correct Answer
E. Internal laryngealExplanation
The superior laryngeal artery accompanies the internal laryngeal nerve into the larynx.Rate this question:
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- 7.
The general sensory innervation of structures in the orbit is via the:
- A.
Facial (VII) nerve
- B.
Trigeminal (V) nerve
- C.
Oculomotor (III) nerve
- D.
Trochlear (IV) nerve
- E.
Sympathetic system
Correct Answer
B. Trigeminal (V) nerveExplanation
The trigeminal (V) nerve is responsible for the general sensory innervation of structures in the orbit. This nerve carries sensory information from the face, including the skin, mucous membranes, and the orbit. It has three main branches: the ophthalmic, maxillary, and mandibular nerves. The ophthalmic branch specifically innervates the orbit and provides sensory information from the eye, including pain, temperature, and touch sensations. Therefore, the trigeminal (V) nerve is the correct answer for this question.Rate this question:
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- 8.
Damage to the facial nerve will result in hyperacusis due to paralysis of which muscle?
- A.
Auricularis posterior
- B.
Tensor tympani
- C.
Stapedius
- D.
Tensor palatine
- E.
Salpingopharyngeus
Correct Answer
C. StapediusExplanation
Damage to the facial nerve will result in hyperacusis due to paralysis of the Stapedius muscle. The Stapedius muscle is responsible for dampening the sound vibrations that enter the ear, specifically by reducing the movement of the stapes bone in the middle ear. When the facial nerve is damaged and the Stapedius muscle becomes paralyzed, it is unable to perform its function of reducing sound vibrations, leading to an increased sensitivity to sound, known as hyperacusis.Rate this question:
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- 9.
A 24‑year‑old man was diagnosed with Bell's (facial nerve) palsy. This is MOST LIKELY to cause:
- A.
Inability to chew
- B.
Atrophy and paralysis of tongue muscles
- C.
Inability to close the eyelid and drooling of saliva out of the affected side of the mouth
- D.
Visual impairment in the eye on the affected side
- E.
Inability to turn the neck
Correct Answer
C. Inability to close the eyelid and drooling of saliva out of the affected side of the mouthExplanation
Bell's palsy is a condition that affects the facial nerve, which controls the muscles of the face. It often leads to weakness or paralysis of the muscles on one side of the face. Inability to close the eyelid and drooling of saliva out of the affected side of the mouth are common symptoms of Bell's palsy. This occurs due to the weakness or paralysis of the muscles responsible for closing the eyelid and controlling saliva production.Rate this question:
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- 10.
Which of the following DOES NOT enter the orbit through the superior orbital fissure?
- A.
Ophthalmic artery
- B.
Abducens nerve
- C.
Oculomotor nerve
- D.
Frontal nerve
- E.
Trochlear nerve
Correct Answer
A. Ophthalmic arteryExplanation
The ophthalmic artery does not enter the orbit through the superior orbital fissure. The superior orbital fissure is a small opening in the skull that allows various structures to pass through and enter the orbit. The abducens nerve, oculomotor nerve, frontal nerve, and trochlear nerve all pass through the superior orbital fissure to enter the orbit. However, the ophthalmic artery enters the orbit through a different opening called the optic canal.Rate this question:
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- 11.
Which of the following DOES NOT get motor supply from the Pharyngeal Plexus?
- A.
Palatoglossus
- B.
Musculus uvulae
- C.
Levator veli palatini
- D.
Tensor veli palatini
- E.
Palatopharyngeus
Correct Answer
D. Tensor veli palatiniExplanation
The tensor veli palatini does not get motor supply from the Pharyngeal Plexus. The Pharyngeal Plexus is responsible for providing motor innervation to the muscles of the pharynx and soft palate. The palatoglossus, musculus uvulae, levator veli palatini, and palatopharyngeus all receive motor supply from the Pharyngeal Plexus, but the tensor veli palatini does not.Rate this question:
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- 12.
The path by which lymphatics normally drain the tongue include
- A.
Tip to supraclavicular; body to submental nodes
- B.
Tip to deep cervical nodes; body to submental nodes
- C.
Tip to jugulodigastric nodes; root to infraclavicular
- D.
Tip to submental nodes; body to deep cervical
- E.
Tip to apical axillary; body to parotid nodes
Correct Answer
D. Tip to submental nodes; body to deep cervicalExplanation
The correct answer is "tip to submental nodes; body to deep cervical." This means that lymphatics from the tip of the tongue drain into the submental lymph nodes, while lymphatics from the body of the tongue drain into the deep cervical lymph nodes. This is the normal drainage pathway for lymphatics from the tongue.Rate this question:
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- 13.
Which of the following structures of the adult head and neck are derivatives of the third pharyngeal arch?
- A.
Superior horn of the thyroid cartilage, aryepiglottic folds, and cuneiform cartilages
- B.
Epiglottis, palatapharyngeus muscle, and superior pharyngeal constrictor muscles
- C.
Pterygomandibular raphe, tensor veli palatini muscle, and anterior belly of the digastric
- D.
Lesser horn of the hyoid bone, stapedius muscles, and stylohyoid ligament
- E.
Greater horn of the hyoid bone, stylopharyngeus muscles, and lateral glossoepiglottic folds
Correct Answer
E. Greater horn of the hyoid bone, stylopharyngeus muscles, and lateral glossoepiglottic foldsExplanation
The greater horn of the hyoid bone, stylopharyngeus muscles, and lateral glossoepiglottic folds are derivatives of the third pharyngeal arch. The third pharyngeal arch gives rise to structures that are involved in swallowing and speech production. The greater horn of the hyoid bone is a bony structure that forms part of the hyoid bone, which supports the tongue and the larynx. The stylopharyngeus muscles are responsible for elevating the pharynx during swallowing. The lateral glossoepiglottic folds are folds of tissue that help to seal off the larynx during swallowing to prevent food and liquid from entering the airway.Rate this question:
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- 14.
One muscle is responsible both for protraction and retraction of the tongue. This muscle is:
- A.
Mylohyoid
- B.
Genioglossus
- C.
Palatoglossus
- D.
Hyoglossus
- E.
Styloglossus
Correct Answer
B. GenioglossusExplanation
The genioglossus muscle is responsible for both protraction and retraction of the tongue. It is located at the base of the tongue and plays a crucial role in movements such as sticking out the tongue and pulling it back into the mouth. This muscle helps in various functions such as swallowing, speaking, and chewing.Rate this question:
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- 15.
During swallowing which muscle exerts pull on the wall of the auditory tube, effecting equalization of pressure between nasopharynx and middle ear cavity?
- A.
Superior pharyngeal constrictor
- B.
Salpingopharyngeus
- C.
Tensor tympani
- D.
Stapedius
- E.
Musculus uvulae
Correct Answer
B. SalpingopharyngeusExplanation
During swallowing, the muscle that exerts pull on the wall of the auditory tube, effecting equalization of pressure between nasopharynx and middle ear cavity, is the Salpingopharyngeus. This muscle helps to open and close the auditory tube, which connects the middle ear to the back of the throat. By contracting, the Salpingopharyngeus muscle helps to equalize the pressure between the nasopharynx and the middle ear cavity, preventing discomfort or damage to the ear.Rate this question:
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- 16.
During the surgical removal of a cancerous thyroid gland in a 71‑year‑old female patient, her left recurrent laryngeal nerve is accidentally severed. The effect(s) will be:
- A.
Need for artificial respiratory support because of the inability to abduct the vocal folds
- B.
Hoarseness
- C.
Loss of the cough reflex because of denervation of the larynx above the vocal folds
- D.
Inability to speak because of paralysis of all the intrinsic laryngeal muscles (except cricothyroideus)
- E.
Inability to swallow due to paralysis of the pharyngeal constrictors
Correct Answer
B. HoarsenessExplanation
Accidentally severing the left recurrent laryngeal nerve during the surgical removal of the thyroid gland can result in hoarseness. The recurrent laryngeal nerve innervates the muscles responsible for controlling the tension and position of the vocal folds. When this nerve is damaged, it can lead to a change in the voice quality, causing hoarseness. The other effects mentioned in the options are not directly related to the function of the recurrent laryngeal nerve.Rate this question:
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- 17.
During childbirth, an expectant mother is admonished to “push”. What combination of muscles does the mother use to perform this Valsalva maneuver and increase her intra‑abdominal pressure?
- A.
Pectoralis minor and major, stylopharyngeus, and scalenes
- B.
Thyroarytenoid, cricothyroid, and trapezius
- C.
Sternocleidomastoid, scalenes, and cricothyroid
- D.
Serratus posterior superior and inferior, external intercostals, and posterior cricoarytenoid
- E.
Lateral cricoarytenoid, arytenoids, and external oblique
Correct Answer
E. Lateral cricoarytenoid, arytenoids, and external oblique -
- 18.
An emergency cricothyroidostomy is performed
- A.
Through the conus elasticus of the larynx
- B.
Superior to the vocal folds but inferior to the vestibular folds
- C.
In the midline through the median cricothyroid ligament
- D.
Inferior to the cricoid cartilage
- E.
Through the lamina of the thyroid cartilage
Correct Answer
C. In the midline through the median cricothyroid ligamentExplanation
The correct answer is "In the midline through the median cricothyroid ligament." This is the correct location for performing an emergency cricothyroidostomy. The median cricothyroid ligament is a strong ligament that connects the cricoid cartilage to the thyroid cartilage. By making an incision through this ligament in the midline, a surgical airway can be established quickly and effectively in emergency situations.Rate this question:
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- 19.
A 34‑year‑old female patient who had been prescribed eye drops for a seasonal allergy complains to her physician that she tastes the drops every time she uses them. Through which of the following mechanisms did the patient MOST LIKELY taste the eye drops?
- A.
Drainage into the oropharynx via a pharyngeal fistula and sensation by taste buds on the posterior third of the tongue
- B.
Drainage through the nasolacrimal duct to pharyngeal taste buds
- C.
Drainage through the frontonasal duct to epiglottic taste buds
- D.
Drainage into the nasal cavity and sensation via the vomeronasal organ
- E.
Drainage into the oral cavity via the incisive foramen and sensation by taste buds on the anterior two thirds of the tongue
Correct Answer
B. Drainage through the nasolacrimal duct to pharyngeal taste budsExplanation
The patient most likely tasted the eye drops due to drainage through the nasolacrimal duct to pharyngeal taste buds. The nasolacrimal duct connects the lacrimal sac to the nasal cavity, allowing tears to drain into the nose. If the eye drops are not properly absorbed or if there is excessive tear production, the drops can enter the nasolacrimal duct and reach the back of the throat, where the taste buds are located. This can lead to the sensation of tasting the drops.Rate this question:
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- 20.
An 11‑year‑old female was brought into the Emergency Room complaining of a fish bone stuck in her throat. She was accompanied by her father who explained that the family had been at a fish barbeque when his daughter had suddenly grabbed her throat and started coughing violently. Coughing had not dislodged the bone, but she was able to breathe without difficulty. Any attempt to swallow, however, was painful because of the obstruction. Where is the bone likely to be lodged?
- A.
The laryngeal ventricle
- B.
The piriform recess
- C.
The vallecula
- D.
The laryngeal sinus
- E.
The scaphoid fossa
Correct Answer
B. The piriform recessExplanation
The bone is likely to be lodged in the piriform recess. The piriform recess is a narrow space located between the aryepiglottic fold and the thyroid cartilage. It is a common site for foreign bodies, such as fish bones, to become lodged in the throat. The symptoms described, including difficulty swallowing and pain, are consistent with an obstruction in the piriform recess.Rate this question:
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Mar 19, 2023Quiz Edited by
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Feb 14, 2012Quiz Created by
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