Block 5 Anat Pharynx Ear Mini Quest Prt 7

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| By Chachelly
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  • 1/18 Questions

    Practice questions on the EAR. A patient was diagnosed of tumor in the middle ear on the right side. After some time he complained of loss of the taste over the anterior part of the tongue. Which of the following nerves was MOST LIKELY damaged by the tumor?

    • Lesser petrosal nerve
    • Chorda tympani nerve
    • Facial nerve just proximal to the stylomastoid foramen
    • Greater petrosal nerve
    • Tympanic branch of the CN9th
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Block 5 Anat Pharynx Ear Mini Quest Prt 7 - Quiz
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  • 2. 

    A 60-year old man has paralysis on the right side of her face. Has difficulty in chewing and perceives sound annoyingly loud. Physical examination reveals loss of taste on ant 2/3 of tongue. The hyperacusis in this case is due to involvement of:

    • Auditory nerve

    • Lesser petrosal nerve

    • Greater petrosal nerve

    • Nerve to stapedius

    • Cordatympanic nerve

    Correct Answer
    A. Nerve to stapedius
    Explanation
    The nerve to stapedius is responsible for innervating the stapedius muscle in the middle ear, which helps to dampen sound vibrations. When this nerve is involved, it can lead to hyperacusis, or the perception of sound as annoyingly loud. The other options listed do not directly innervate the stapedius muscle and therefore would not be responsible for the hyperacusis symptoms described.

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  • 3. 

    Which of the following muscle is supplied by the Glossopharyngeal nerve?

    • Middle constrictor

    • Superior constrictor

    • Stylopharyngeus

    • Palatopharyngeus

    • Salpingopharyngeus

    Correct Answer
    A. Stylopharyngeus
    Explanation
    The Stylopharyngeus muscle is supplied by the Glossopharyngeal nerve. The Glossopharyngeal nerve is responsible for innervating the muscles of the pharynx, including the Stylopharyngeus muscle. This muscle is involved in swallowing and helps elevate and widen the pharynx during swallowing. It is important for the proper functioning of the swallowing process.

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  • 4. 

    A 25-year old woman visited her physician complaining of a swelling on the front of her neck and breathlessness. On examination, a small, solitary swelling of firm consistency was found to the left of the midline of the neck. The swelling moved upward on swallowing. The swelling is related to one of the following structures.

    • Trachea

    • Esophagus

    • Parathyroid glands

    • Thyroid gland

    • Deep cervical lymph nodes

    Correct Answer
    A. Thyroid gland
    Explanation
    The correct answer is the thyroid gland. The symptoms of a swelling on the front of the neck and breathlessness, along with the movement of the swelling upon swallowing, suggest an issue with the thyroid gland. The thyroid gland is located in the front of the neck and can become enlarged, causing a visible swelling known as a goiter. This can lead to compression of the nearby structures, resulting in breathlessness.

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  • 5. 

    A 6-year old boy was playing with some coins. He put a nickel into his mouth and accidentally swallowed it. He began to cough, drool and choke. He was rushed to the hospital. A lateral radiograph of his neck revealed that the coin was lodged in his lower pharynx. Where would the coin probably lodge?

    • Vallecula

    • Tonsillar sinus

    • Piriform recess

    • Esophagus

    • Laryngeal sinus

    Correct Answer
    A. Piriform recess
    Explanation
    The coin would most likely lodge in the piriform recess. The piriform recess is a small depression in the wall of the pharynx, located on either side of the laryngeal inlet. It is a common site for foreign bodies to become lodged, especially in cases of accidental ingestion. In this case, the symptoms of coughing, drooling, and choking are indicative of the coin being stuck in the lower pharynx, which aligns with the location of the piriform recess.

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  • 6. 

    A 50-year old man has a partial thyroidectomy for a tumor. During the operation the internal laryngeal nerve was damaged. Which of the following structures will lose the sensation?

    • Over the epiglottis only

    • The larynx above the vocal cord

    • The larynx below the vocal cord

    • The ventricle of the larynx

    • The saccule of the larynx only

    Correct Answer
    A. The larynx above the vocal cord
    Explanation
    During a partial thyroidectomy, if the internal laryngeal nerve is damaged, the sensation will be lost in the larynx above the vocal cord. The internal laryngeal nerve provides sensory innervation to the larynx above the vocal cord, so damage to this nerve will result in loss of sensation in that area. The other structures mentioned in the options (epiglottis, larynx below the vocal cord, ventricle of the larynx, and saccule of the larynx) are not innervated by the internal laryngeal nerve, so they will not be affected.

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  • 7. 

    Usually middle ear gets infection from one the following sites.

    • External ear

    • Internal ear

    • Nasopharynx

    • Mastoid air cells

    • Middle cranial fossa

    Correct Answer
    A. Nasopharynx
    Explanation
    The middle ear commonly gets infected from the nasopharynx. This is because the middle ear is connected to the nasopharynx through the Eustachian tube. The Eustachian tube helps equalize the pressure between the middle ear and the outside environment. However, it can also allow bacteria or viruses from the nasopharynx to travel up into the middle ear, causing infection. This is especially common in children, as their Eustachian tubes are shorter and more horizontal, making it easier for pathogens to travel from the nasopharynx to the middle ear.

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  • 8. 

    An abscess in the middle ear if not drained, will rupture at one of the following sites

    • Nasopharynx

    • Auditory tube

    • Tympanic membrane

    • Internal ear

    • Middle cranial fossa

    Correct Answer
    A. Tympanic membrane
    Explanation
    An abscess in the middle ear is a collection of pus that forms due to an infection. If left untreated, the pressure from the pus buildup can cause the abscess to rupture. The tympanic membrane, also known as the eardrum, separates the middle ear from the outer ear. Since the abscess is located in the middle ear, it is most likely to rupture through the tympanic membrane, as it is the thinnest barrier between the middle ear and the outside.

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  • 9. 

    A 58- year old woman has a paralysis on the right side of her face. She has difficulty in chewing and perceives sounds as annoyingly loud. Physical examination reveals loss of taste on the right anterior 2/3’s of the tongue. The hyperacusis in this case results from involvement of the

    • Auditory nerve

    • Chorda tympani nerve

    • Nerve to stapedius

    • Lesser petrosal nerve

    • Greater petrosal nerve

    Correct Answer
    A. Nerve to stapedius
    Explanation
    The correct answer is "nerve to stapedius". The patient's symptoms of paralysis on the right side of her face, difficulty in chewing, and perception of sounds as annoyingly loud suggest that there is involvement of the facial nerve. The nerve to stapedius is a branch of the facial nerve that innervates the stapedius muscle in the middle ear. Dysfunction of this nerve can lead to hyperacusis, which is the perception of sounds as excessively loud.

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  • 10. 

    An ENT surgeon performed the tonsillectomy on 15-year-old boy. After the operation the surgeon noticed severe bleeding from the tonsillar bed. Which of the following arteries is responsible for the bleeding?

    • Tonsilar branch of lingual artery

    • Tonsilar branch of maxillary artery

    • Tonsilar branch of the facial artery

    • Tonsilar branch of the ascending pharyngeal artery

    • Tonsilar branch of the internal carotid artery

    Correct Answer
    A. Tonsilar branch of the facial artery
    Explanation
    The tonsilar branch of the facial artery is responsible for the severe bleeding from the tonsillar bed after the tonsillectomy. This artery supplies blood to the tonsils and can cause significant bleeding if damaged during the surgery.

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  • 11. 

    A 40-year old woman has a partial thyroidectomy for the treatment of thyrotoxicisis. During the operation a ligature slipped off the right superior thyroid artery. In order to stop the bleeding, the surgeon blindly grabbed for the artery with artery forceps. The operation was completed without further incident. The next morning the surgeon noticed that the patient spoke with a husky voice. Which of the following structures was damaged during the operation?

    • Glossopharyngeal nerve

    • Left external laryngeal nerve

    • Right external laryngeal nerve

    • Right recurrent laryngeal nerve

    • Left recurrent laryngeal nerve

    Correct Answer
    A. Right external laryngeal nerve
    Explanation
    During the operation, the ligature slipping off the right superior thyroid artery caused bleeding. To stop the bleeding, the surgeon blindly grabbed for the artery with artery forceps. The fact that the patient spoke with a husky voice the next morning suggests that a nerve related to the larynx was damaged during the operation. The right external laryngeal nerve is responsible for innervating the cricothyroid muscle, which controls the tension of the vocal cords. Damage to this nerve can result in hoarseness or a husky voice. Therefore, the correct answer is the right external laryngeal nerve.

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  • 12. 

    A 15-year old boy was admitted to the hospital with sore throat and earache. He had a high fever, rapid pulse and rapid respiration. Physical examination by physician revealed diffuse redness and swelling of the palatine tonsils. The physician decided to perform the tonsillectomy. After the operation the physician noted hemorrhage. What is the probable source of the hemorrhage in this case?

    • Tonsillar branch of the lingual artery

    • Maxillary artery

    • External palatine vein

    • Ascending pharyngeal artery

    • Internal carotid artery

    Correct Answer
    A. External palatine vein
    Explanation
    The probable source of hemorrhage in this case is the external palatine vein. The symptoms described, such as sore throat, earache, high fever, and rapid pulse and respiration, suggest an infection or inflammation of the tonsils. Tonsillectomy is a surgical procedure to remove the tonsils, and it is common for bleeding to occur after the surgery. The external palatine vein is located near the tonsils and is at risk of being damaged during the procedure, leading to post-operative hemorrhage.

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  • 13. 

    A 70-year-old man suffered from the progressive hearing loss in the right ear for the last two weeks. The patient consulted the physician. The physician conducted Rinne’s test in the right ear and detected Bone conduction>Air conduction. Later the physician conducted Weber’s test and detected that the patient heared louder on the right side than the left. Which of the following structures is involved in the right ear?

    • Internal ear

    • External ear

    • Cochlear nerve

    • Cochlear nuclei

    • Cortical deafness

    Correct Answer
    A. External ear
    Explanation
    The correct answer is the External ear. The progressive hearing loss in the right ear, along with the results of Rinne's and Weber's tests, suggest a conductive hearing loss in the right ear. In Rinne's test, bone conduction is greater than air conduction, indicating a problem in the external or middle ear. In Weber's test, hearing louder on the right side suggests a problem in the right ear. Therefore, the involvement of the external ear is likely causing the hearing loss in the right ear.

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  • 14. 

    A 60-year-old man visited the physician for the chronic ear pain on the right side and paralysis on the right side of the face for the last two months. Physical examination reveals loss of taste on the right anterior 2/3’s of the tongue, perceives sounds as annoyingly loud but no dryness of the right eye. The physician confirms that the facial nerve is damaged in the middle ear. Facial nerve is damaged at one of the following sites.

    • AT the internal auditory meatus

    • At the geniculate ganglion

    • Distal to origin of nerve to stapedius

    • Proximal to origin of nerve to stapedius

    • Distal to origin of chorda tympanic nerve

    Correct Answer
    A. Proximal to origin of nerve to stapedius
    Explanation
    The patient's symptoms, including chronic ear pain, paralysis on the right side of the face, loss of taste on the right anterior 2/3's of the tongue, and perceiving sounds as annoyingly loud, suggest damage to the facial nerve. The fact that there is no dryness of the right eye indicates that the facial nerve is damaged proximal to the origin of the nerve to the stapedius muscle, as this muscle is responsible for tear production. Therefore, the correct answer is proximal to the origin of the nerve to stapedius.

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  • 15. 

    Middle ear gets its sensory innervation through the

    • Auriculotemporal nerve

    • Facial nerve

    • Auricular branch of the vagus

    • Glossopharyngeal nerve

    • Lesserpetrosal nerve

    Correct Answer
    A. Glossopharyngeal nerve
    Explanation
    The glossopharyngeal nerve provides sensory innervation to the middle ear. This nerve is responsible for transmitting sensory information from the posterior part of the tongue, the soft palate, and the pharynx. It also supplies sensory fibers to the middle ear, allowing for the perception of sound and maintaining balance. The other options listed do not provide sensory innervation to the middle ear.

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  • 16. 

    Which of the following nerves supplies the sensory fibers to the middle ear and carries presynaptic parasympathetic fibers to the parotid gland?  

    • Facial nerve

    • Lesser petrosal nerve

    • Greater petrosal nerve

    • Tympanic branch of glossopharyngeal nerve

    • Auriculotemporal nerve

    Correct Answer
    A. Tympanic branch of glossopharyngeal nerve
    Explanation
    The tympanic branch of the glossopharyngeal nerve supplies the sensory fibers to the middle ear and carries presynaptic parasympathetic fibers to the parotid gland. This nerve is responsible for transmitting sensory information from the middle ear to the brain and also plays a role in the regulation of salivation by providing parasympathetic innervation to the parotid gland.

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  • 17. 

    The external ear is supplied by

    • One cranial nerve

    • Two cranial nerves

    • Three cranial nerves

    • Four cranial nerves

    • Five cranial nerves

    Correct Answer
    A. Four cranial nerves
    Explanation
    The external ear is supplied by four cranial nerves. These cranial nerves are the trigeminal nerve (V), the facial nerve (VII), the glossopharyngeal nerve (IX), and the vagus nerve (X). The trigeminal nerve provides sensory innervation to the skin of the external ear, while the facial nerve supplies the muscles of the ear. The glossopharyngeal nerve and the vagus nerve contribute to the innervation of the external ear through their connections with the auricular branch of the vagus nerve. These four cranial nerves work together to provide sensation and movement to the external ear.

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  • 18. 

    A patient suffers from acoustic neuroma of the internal auditory meatus and produced the following clinical signs except:  

    • Unilateral nerve deafness

    • Nausea, vimiting and vertigo

    • Lower facial paralysis

    • Loss of corneal reflex

    • Stapedius paralysis

    Correct Answer
    A. Lower facial paralysis
    Explanation
    Acoustic neuroma is a benign tumor that develops on the nerve responsible for hearing and balance. It typically causes symptoms such as unilateral nerve deafness, nausea, vomiting, vertigo, and loss of corneal reflex. However, lower facial paralysis is not a clinical sign associated with acoustic neuroma. This is because the tumor affects the vestibulocochlear nerve (responsible for hearing and balance) and not the facial nerve (responsible for facial movements). Therefore, lower facial paralysis would not be expected in a patient with acoustic neuroma.

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  • Current Version
  • Jul 22, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Feb 16, 2012
    Quiz Created by
    Chachelly
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