Block 5 Anat Pharynx Ear Mini Quest Prt 7

The chorda tympani nerve is the branch of the facial nerve that provides taste sensation to the anterior two-thirds of the tongue. In this case, the tumor in the middle ear on the right side most likely damaged the chorda tympani nerve, leading to the loss of taste over the anterior part of the tongue.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.