Block 5 Anat Temp Fossa Verteb Region Ta's W Expl
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- 1.A 55-year-old man undergoes surgery on his parotid gland. When presenting for a follow-up visit one month later, he reports feeling his skin damp over his surgical site when he eats. The surgeon replies that this is likely a consequence of his surgery. He explains that this is likely because of incorrect regeneration of which of the following nerves?
- A.
Lesser petrosal nerve
- B.
Greater petrosal nerve
- C.
Auriculotemporal nerve
- D.
Inferior alveolar nerve
- E.
Superficial temporal nerve
- 2.Which of the following structures is formed by branching while in the infratemporal fossa?
- A.
Chorda tympani branching from the lingual nerve
- B.
Chorda tympani branching from the facial nerve
- C.
Nerve to mylohyoid branching from the lingual nerve
- D.
Nerve to mylohyoid branching from the facial nerve
- E.
Middle meningeal artery branching from the superficial temporal artery
- F.
Middle meningeal artery branching from the maxillary artery
- G.
Lingual artery branching from the external carotid artery
- H.
Lingual artery branching from the maxillary artery
- 3.Mr. Chotas, a budding medical student, underwent surgery for his impacted mandibular third molar. As a good doctor, the surgeon warns Mr. Chotas about the possible lasting numbness in the tip of his tongue. This loss of general sensation is due to the damage of what nerve?
- A.
Auriculotemporal nerve
- B.
Chorda tympani
- C.
Lingual nerve
- D.
Mental nerve
- E.
Nerve to mylohyoid
- 4.A 65-yo, female presents to your primary care clinic after undergoing extensive facial plastic surgery in Beverly Hills. The surgery was uneventful, and the patient is very satisfied with the results. However, lately she has been complaining of difficulty swallowing her food. She says that she feels like she always has to take a drink of water when chewing and swallowing meals. Furthermore, the patient describes polydipsia and consequently polyuria but no trouble expressing facial emotions. As a knowledgeable physician, you begin exploring possible differentials given the patient's presentation and history and you suspect that the surgeon may have cut a nerve contributing to your patient's symptoms. Which nerve and respective modality was MOST LIKELY injured in this patient?
- A.
Facial n.; GSE
- B.
Facial n.; GVE
- C.
Glossopharyngeal n.; GSE
- D.
Facial n.; GSA
- E.
Glossopharyngeal n.; GVE
- 5.A physician takes a small feather and touches the anterior portion of his patients tongue. The patient asks what does that test? Thinking back to your anatomy you reply?
- A.
Taste of Anterior 2/3 of tongue via CN VII
- B.
Taste of Anterior 2/3 of tongue via CN IX
- C.
General sensation of Anterior 2/3 of tongue via CN VII
- D.
General sensation of Anterior 2/3 of tongue via CN V division 3
- 6.A 25 year old man comes into the ER after getting into a street brawl late Friday night, the right side of his face is extremely swollen, he also complains of dry mouth and an x-ray is taken. Results show a fracture of the neck of the mandible, what is the origin of the parasympathetic nerve you suspect to be damaged?
- A.
Glossopharyngeal
- B.
Facial
- C.
Trigeminal
- D.
Lingual
- 7.A patient undergoes removal of a parotid adenoma, resulting in removal of her left parotid gland. Which of the following can be a likely complication resulting from parotid gland surgery?
- A.
Loss of pain and temperature on the left side of her face
- B.
Loss of light touch and proprioception on the left side of her face
- C.
Drooping of her left face
- D.
Hoarseness
- E.
Drooping of her left shoulder
- 8.The parotid gland is innervated by CN , via the ganglion. Once the gland is stimulated it secretes fluid through the duct.
- A.
VII, PPG, serous, Wharton
- B.
IX, Otic, mucinous, Wharton
- C.
VII, PPG, mucinous, Stensens
- D.
IX, Otic, serous, Stensens
- 9.The parasympathetic innervation of the parotid gland involves the glossopharyngeal nerve to hitch hike onto other nerves. What is the correct sequence from the tympanic plexus to the parotid gland?
- A.
Tympanic nerve → Otic ganglion → Auriculotemporal nerve of V3 → to parotid gland
- B.
Greater petrosal nerve → Otic ganglion → Auriculotemporal nerve of V3 → to parotid gland
- C.
Lesser petrosal nerve → Otic ganglion → Auriculotemporal nerve of V3 → to parotid gland
- D.
Lesser petrosal nerve → Tympanic ganglion → Auriculotemporal nerve of V2 → to parotid gland
- 10.What is the function of the temporalis muscle?
- A.
Elevates and protrudes the mandible
- B.
Elevates and retracts the mandible
- C.
Depresses and protrudes mandible
- D.
Depresses and retracts mandible
- 11.A 28-year old lady is involved in a motor accident. After the accident, she presents to your clinic because she has difficulty in opening her mouth, but has no difficulty in closing it. Which of the following muscles was MOST LIKELY damaged?
- A.
Medial pterygoid
- B.
Masseter
- C.
Lateral pterygoid
- D.
Temporalis
- E.
Orbicularis oris
- 12.A 56-year-old woman undergoes a partial thyroidectomy for a malignant tumor. During the operation the internal laryngeal nerve was damaged. Which of the following structures will lose sensation?
- A.
Over the epiglottis only
- B.
The larynx below the vocal cord
- C.
The ventricle of the larynx
- D.
The larynx above the vocal cord
- E.
The saccule of the larynx only
- 13.A 65-year-old man has difficulty swallowing and frequently aspirates fluids while drinking. MRI scan reveals that he has a tumor near the jugular foramen. Involvement of which structure is responsible for the presenting symptoms?
- A.
Ansa cervicalis
- B.
Vagus Nerve
- C.
Cervical sympathetic trunk
- D.
Accessory nerve
- E.
Hypoglossal nerve
- 14.A 56 year old male comes into the clinic and is diagnosed with Horner's Syndrome. Which one of the following will he not suffer from?
- A.
Miosis
- B.
Mydriasis
- C.
Ptosis
- D.
Anhidrosis
- 15.A 37 year old female went to see her primary care physician complaining of sharp, burning and aching pain in the 4th and 5th digits in her left hand. The physician orders an MRI and the results reveal massive inflammation of her left anterior scalene muscle. Which of the following nerves innervates the anterior scalene muscle?
- A.
Dorsal ramus of C3 and C4
- B.
Ventral ramus of C3 and C4
- C.
Spinal accessory nerve
- D.
Dorsal ramus of C4 to C6
- E.
Ventral ramus of C4 to C6
- 16.A 54 year old female undergoes thyroidectomy. While ligating the superior thyroid artery, the surgeon accidentally severs a nearby nerve. Which of the following muscles is denervated as a result of this injury?
- A.
Thyroarytenoid
- B.
Lateral cricoarytenoid
- C.
Posterior cricoarytenoid
- D.
Cricothyroid
- E.
Aryepiglotticus
- 17.The lesser petrosal nerve carries preganglionic parasympathetic fibers to the:
- A.
Geniculate ganglion
- B.
Otic ganglion
- C.
Submandibular ganglion
- D.
Ciliary ganglion
- 18.The internal laryngeal nerve branches directly off which nerve?
- A.
Vagus nerve
- B.
Recurrent laryngeal nerve
- C.
External laryngeal nerve
- D.
Superior laryngeal nerve
- E.
Inferior laryngeal nerve
- 19.The external and internal laryngeal nerves are branches of the superior laryngeal nerve (which is a branch of the vagus nerve). Which of the following is correct?
- A.
External laryngeal provides sensory innervation to the larynx above the vocal cords
- B.
The internal laryngeal provides motor innervation to the larynx
- C.
The internal laryngeal provides sensory innervation to the larynx above the vocal cords.
- D.
The internal laryngeal provides sensory innervation to the vocal cords.
- 20.A 60-year-old man with a history significant for arteriosclerosis and hypertension presents with recent onset of periodic syncopal episodes. Upon performing an angiogram, the physician notes significant stenosis of the internal carotid artery; however, the patient's collateral arterial circulation is able to sustain blood flow to his brain. Which of the following vessels provide an anastamosis for the internal carotid artery as it enters the skull?
- A.
Superficial temporal artery
- B.
Angular artery
- C.
Superior thyroid artery
- D.
Suprascapular artery
- E.
Ascending cervical artery
- 21.During thyroidectomy, the surgeon ligates the most inferior vessel supplying blood to the gland. Trace the vessel back to its origin.
- A.
Inferior thyroid A. → Costocervical trunk → Subclavian A. → Aorta
- B.
Inferior thyroid A. → Costocervical trunk → Brachiocephalic trunk → Aorta
- C.
Inferior thyroid A. → Thyrocervical trunk → Subclavian A. → Aorta
- D.
Inferior thyroid A. → Thyrocervical trunk → Common Carotid A. → Aorta
- 22.During the winter, a patient comes to your office with chief complaints of unexpectedly sweaty skin on the left side of her face. On physical exam, her left pupil diameter is notably larger than the left. Which of the following best describes information involved with this case?
- A.
The patient has trigeminal neuralgia
- B.
The patient is showing signs of Horner's syndrome
- C.
The patient will need to be treated by stimulating one of the cervical chain ganglia
- D.
The patient will need to be treated by paralyzing the stellate ganglion
- E.
The patient has an early stage of a Pancoast tumor
- 23.Mr. Jones presents to your office 3 days after completing a partial thyroidectomy due to a follicular thyroid carcinoma involving the right and left lateral thyroid lobes. The patient is complaining of hoarseness in his voice and just not feeling "right" lately. Furthermore, EKG and lab results indicate that Mr. Jones has a slight cardiac arrhythmia that which you suspect may be related to his abnormally low serum calcium levels. You begin to worry that the surgeon may have mistakenly removed the parathyroid glands and injured a nerve in close proximity to the thyroid gland. Which artery runs in close proximity with the nerve that was MOST likely damaged in this patient?
- A.
Subclavian a.
- B.
Superior thyroid a
- C.
Internal Carotid a.
- D.
Inferior thyroid a.
- E.
External Carotid a.
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