Block 5 Anat Larynx Neck Mini Quest Prt 8
Chaudry's
Questions and Answers
- 1.
A patient suffers from the aneurysm of the arch of aorta and the left recurrent laryngeal nerve is damaged. Which of the following muscles is first to be involved?
- A.
Cricothyroid
- B.
Lateral cricoarytenoid
- C.
Posterior cricoarytenoid
- D.
Thyroarytenoid
- E.
Thyroepiglottis
Correct Answer
C. Posterior cricoarytenoidExplanation
When the left recurrent laryngeal nerve is damaged, it leads to paralysis of the muscles innervated by this nerve. The posterior cricoarytenoid muscle is the only muscle listed that is innervated by the recurrent laryngeal nerve. Therefore, it is the first muscle to be involved in this situation.Rate this question:
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- 2.
A student was shot by a bullet in the left side of the neck. The wound left him bleeding peofusely and paralyzed the sternocleidomastoid, trapezius and stylopharyngeus muscles on the same side. The posterior third of the tongue lost taste sensation. The left recurrent laryngeal nerve was damaged and left him with a hoarse throat. The bullet had pierced which of the following sites?
- A.
Carotid canal
- B.
Foramen magnum
- C.
Jugular foramen
- D.
Foramen lacerum
- E.
Superior orbital fissure
Correct Answer
C. Jugular foramenExplanation
The bullet pierced the jugular foramen. This is evident from the symptoms described in the question. The jugular foramen is a large opening in the base of the skull through which the internal jugular vein and several cranial nerves pass. Damage to the nerves passing through the jugular foramen can result in various symptoms including loss of taste sensation, hoarseness, and paralysis of certain muscles, all of which are mentioned in the question. Therefore, the bullet must have pierced the jugular foramen to cause these specific symptoms.Rate this question:
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- 3.
A 10-year old boy was taken to a doctor because his mother noticed that he held his head inclined to the right. On examination, the cervical vertebral column was held in a position of slight flexion and right ear was held nearer his right shoulder. Contraction of which of the following muscles is MOST LIKELY responsible for this condition.
- A.
Right trapezius
- B.
Left spleneus capitis
- C.
Right sternocleidomastoid
- D.
Right levator scapulae
- E.
Left trapezius
Correct Answer
C. Right sternocleidomastoidExplanation
The right sternocleidomastoid muscle is most likely responsible for the boy's condition because its contraction would cause the head to be inclined to the right and the right ear to be held closer to the right shoulder. The sternocleidomastoid muscle is located on the side of the neck and helps with movements such as tilting and rotating the head.Rate this question:
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- 4.
A 60-year old man was operated for the removal of the lymph nodes in the carotid triangle. The operation was successful. After about a month the same patient came back to the surgeon and complained of a weak voice. Which of the following structures was damaged during the operation?
- A.
Ansa cervicalis
- B.
External laryngeal nerve
- C.
Internal laryngeal nerve
- D.
Hypoglossal nerve
- E.
Sympathetic trunk
Correct Answer
B. External laryngeal nerveExplanation
During the removal of lymph nodes in the carotid triangle, the external laryngeal nerve may have been damaged. The external laryngeal nerve is responsible for innervating the cricothyroid muscle, which is important for controlling the tension of the vocal cords. Damage to this nerve can result in a weak voice, as seen in the patient's complaint. The other structures listed, such as the ansa cervicalis, internal laryngeal nerve, hypoglossal nerve, and sympathetic trunk, are not directly involved in vocal cord function and would not likely cause a weak voice.Rate this question:
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- 5.
A patient was brought to the ER with upper chest wound. After careful examination it was found a knife wound to the chest wall above the clavicle and the following structures were damaged except:
- A.
Subclavian artery
- B.
Lower trunk of the brachial plexus
- C.
Sympathetic trunk
- D.
Cervical pleura
- E.
Apex of the lung
Correct Answer
C. Sympathetic trunkExplanation
The sympathetic trunk is a bilateral chain of ganglia and nerve fibers that runs along the vertebral column. It is responsible for transmitting sympathetic nerve impulses to various parts of the body. In this case, the patient has a knife wound to the chest wall above the clavicle. The structures that are listed as options are all located in the upper chest region. However, the sympathetic trunk is not located in the upper chest, but rather runs along the vertebral column. Therefore, it would not be damaged in this particular injury.Rate this question:
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- 6.
In closing the inlet of the larynx during the swallowing, which of the following muscles is acting MOST?
- A.
Thyroarytenoid
- B.
Aryepiglottis
- C.
Lateral cricoarytenoid
- D.
Posterior cricoarytenoid
- E.
Thyroepiglottis
Correct Answer
B. AryepiglottisExplanation
The aryepiglottis muscle is the muscle that is acting the most in closing the inlet of the larynx during swallowing. The aryepiglottis muscle is responsible for pulling the epiglottis down and closing off the entrance to the larynx, preventing food or liquid from entering the airway. This muscle helps to ensure that swallowed material goes down the esophagus and into the stomach, rather than entering the lungs.Rate this question:
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- 7.
Which of the following muscles is supplied by the external laryngeal nerve?
- A.
Posterior cricoarytenoid
- B.
Lateral cricoarytenoid
- C.
Thyroarytenoid
- D.
Cricothyroid
- E.
Thyroepiglottis
Correct Answer
D. CricothyroidExplanation
The cricothyroid muscle is supplied by the external laryngeal nerve. This nerve is a branch of the superior laryngeal nerve, which originates from the vagus nerve. The external laryngeal nerve provides motor innervation to the cricothyroid muscle, which is responsible for tensing the vocal cords and increasing pitch during phonation. The other muscles listed are not innervated by the external laryngeal nerve.Rate this question:
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- 8.
During the removal a foreign body from the piriform recess, the internal laryngeal nerve was damaged. Which of the following structures will lose the general sensation?
- A.
Posterior third of the tongue
- B.
Larynx, above the vocal cords
- C.
Larynx below the vocal cords
- D.
The ventricles of the larynx only
- E.
The saccule of the larynx only
Correct Answer
B. Larynx, above the vocal cordsExplanation
When the internal laryngeal nerve is damaged, the general sensation will be lost in the larynx above the vocal cords. The internal laryngeal nerve supplies sensory innervation to this area, so when it is damaged, the ability to perceive general sensations such as touch, pain, and temperature in this region will be affected. The other structures mentioned, such as the posterior third of the tongue, larynx below the vocal cords, ventricles of the larynx, and the saccule of the larynx, are not innervated by the internal laryngeal nerve and therefore will not lose general sensation in this scenario.Rate this question:
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- 9.
After the vocal cords are fully adducted, they are opened by which of the following muscles?
- A.
Lateral cricoarytenoid
- B.
Posterior cricoarytenoid
- C.
Thyroarytenoid
- D.
Cricothyroid
- E.
Thyroepigllotis
Correct Answer
B. Posterior cricoarytenoidExplanation
The posterior cricoarytenoid muscle is responsible for opening the vocal cords after they are fully adducted. This muscle contracts to abduct the vocal cords, allowing air to pass through and produce sound. The other muscles listed, such as the lateral cricoarytenoid and thyroarytenoid, are involved in adducting or closing the vocal cords. The cricothyroid muscle is responsible for lengthening and tensing the vocal cords, while the thyroepiglottis muscle is not a recognized muscle in the human body.Rate this question:
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- 10.
A 30-year-old man visited his physician complaining of a swelling on the front of the neck and breathlessness. On examination, a swelling of firm consistency was found to left of the midline of the neck. The swelling moved up and down on swallowing. The swelling is related to one of the following structures.
- A.
Trachea
- B.
Esophagus
- C.
Thyroid gland
- D.
Pharynx
- E.
Larynx
Correct Answer
C. Thyroid glandExplanation
The swelling on the front of the neck that moves up and down on swallowing indicates an issue with the thyroid gland. The thyroid gland is located in the front of the neck and can become enlarged or develop nodules, leading to swelling. This swelling can cause breathlessness due to compression of the airway. The fact that the swelling moves up and down on swallowing suggests that it is connected to the thyroid gland, which moves with swallowing. Therefore, the correct answer is the thyroid gland.Rate this question:
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- 11.
Following a road accident, a patient sustained an injury to the right subclavian artery with the formation of a compressing haematoma around the artery. Such a compression could be associated with following symptoms except
- A.
Hoarse throat
- B.
Palsy of the posterior cricoarytenoid
- C.
Palsy of the lateral cricoarytenoid
- D.
Palsy of the thyroarytenoid
- E.
Palsy of the cricothyroid
Correct Answer
E. Palsy of the cricothyroidExplanation
Compression of the right subclavian artery would not directly cause palsy of the cricothyroid muscle. The cricothyroid muscle is innervated by the external branch of the superior laryngeal nerve, which is not directly affected by compression of the subclavian artery. The symptoms listed in the options are all related to damage or compression of the recurrent laryngeal nerve, which can occur with injury to the subclavian artery.Rate this question:
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- 12.
The vocal folds are found within the space enclosed by the:
- A.
Hyoid bone
- B.
Cricoid cartilage
- C.
Thyroid cartilage
- D.
Piriform recess
- E.
Arytenoid cartilage
Correct Answer
C. Thyroid cartilageExplanation
The vocal folds are located within the space enclosed by the thyroid cartilage. The thyroid cartilage is a large, shield-shaped cartilage that forms the front part of the larynx, commonly known as the Adam's apple. It protects the vocal folds and helps to regulate the tension and position of the vocal cords, which are responsible for producing sound during speech and singing. The other options listed, such as the hyoid bone, cricoid cartilage, piriform recess, and arytenoid cartilage, are not directly involved in enclosing the vocal folds.Rate this question:
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- 13.
Paralysis of what muscle require emergency opening of the airway?
- A.
Cricothyroid
- B.
Posterior cricoarytenoid
- C.
Lateral cricoarytenoid
- D.
Arytenoids
- E.
Vocalis
Correct Answer
B. Posterior cricoarytenoidExplanation
Paralysis of the posterior cricoarytenoid muscle requires emergency opening of the airway. This muscle is responsible for opening the vocal cords during inspiration, allowing air to flow into the lungs. If this muscle is paralyzed, the vocal cords cannot open properly, leading to difficulty in breathing. Opening the airway in this situation is crucial to ensure adequate oxygenation and prevent respiratory distress.Rate this question:
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- 14.
At which two joints does the laryngeal skeleton move?
- A.
Arytenothyroid and epiglottis-thyroid
- B.
Corniculoarytenoid and cuneiform-arytenoid
- C.
Cricothyroid and cricoarytenoid
- D.
Arytenothyroids
- E.
Cricotracheal and thyroepiglottic
Correct Answer
C. Cricothyroid and cricoarytenoidExplanation
The correct answer is Cricothyroid and cricoarytenoid. The laryngeal skeleton is responsible for controlling the movement of the vocal cords and the production of sound. The cricothyroid joint allows for the lengthening and tensing of the vocal cords, while the cricoarytenoid joint allows for the rotation and abduction/adduction of the vocal cords. These movements are crucial for speech and voice production.Rate this question:
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- 15.
In an emergency operation for opening of the airway, which of the following location will be chosen for the incision?
- A.
Just above the hyoid bone
- B.
Thyrohyoid membrane
- C.
Cricothyroid membrane
- D.
Thyroid cartilage
- E.
Just below the cricoid cartilage
Correct Answer
C. Cricothyroid membraneExplanation
The cricothyroid membrane is chosen for the incision in an emergency operation for opening the airway. This is because the cricothyroid membrane is easily accessible and provides a direct route to the trachea for emergency procedures such as a cricothyrotomy or tracheostomy. It is located between the cricoid cartilage and the thyroid cartilage, making it an ideal location for quick and efficient airway access in emergency situations.Rate this question:
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- 16.
The lateral surface of the thyrohyoid membrane is pierced by one of the following nerves:
- A.
External laryngeal nerve
- B.
Glossopharyngeal nerve
- C.
Recurrent laryngeal nerve
- D.
Internal laryngeal nerve
- E.
Inferior laryngeal nerve
Correct Answer
D. Internal laryngeal nerveExplanation
The internal laryngeal nerve pierces the lateral surface of the thyrohyoid membrane.Rate this question:
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- 17.
A 50-year old man presents to the physician only minutes after having suffered a punctured carotid artery. Compression of this artery is most effective against which of the following bony points?
- A.
Pedicle of C5
- B.
Transverse process of C7
- C.
Pedicle of C6
- D.
Transverse process of C6
- E.
Costal facet of T1
Correct Answer
D. Transverse process of C6Explanation
Compression of the carotid artery is most effective against the transverse process of C6. The transverse processes of the cervical vertebrae are bony projections that extend laterally from the sides of the vertebrae. By applying pressure on the transverse process of C6, the physician can effectively compress the carotid artery and control bleeding.Rate this question:
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- 18.
An ENT surgeon performed tonsillectomy on 17-yearold boy. The operation was uneventful. After few weeks the boy complained of the loss of sensation over posterior third of the tongue. Which of the following nerves was damaged during the operation?
- A.
Lingual nerve
- B.
Internal laryngeal nerve
- C.
Glossopharyngeal nerve
- D.
External laryngeal nerve
- E.
External laryngeal nerve
Correct Answer
C. Glossopharyngeal nerveExplanation
The glossopharyngeal nerve is responsible for providing sensory innervation to the posterior third of the tongue. Therefore, if the boy is experiencing a loss of sensation in this area after the tonsillectomy, it is likely that the glossopharyngeal nerve was damaged during the operation.Rate this question:
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- 19.
A surgeon performed partial thyroidectomy on 60-year old man. The operation was uneventful and the patient was sent home. After few weeks the patient complained of the monotonus speech of low pitch. Which of the following nerves was damaged during the operation?
- A.
Lingual nerve
- B.
Glossopharyngeal nerve
- C.
Internal laryngeal nerve
- D.
External laryngeal nerve
- E.
Hypoglossal nerve
Correct Answer
D. External laryngeal nerveExplanation
During a partial thyroidectomy, the external laryngeal nerve may be damaged. This nerve is responsible for controlling the cricothyroid muscle, which helps to adjust the pitch of the voice. Damage to the external laryngeal nerve can result in a monotonous speech of low pitch, which aligns with the symptoms described by the patient.Rate this question:
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