Block 5 Anatomy Wk 3 From Ta's W Exp

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| By Chachelly

Chachelly

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| Attempts: 174 | Questions: 19

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1. A lesion to the chorda tympani nerve would cause what clinical sign?

Patient complaining of swollen cheek

Patient complaining of loss of somatic sensation to anterior 2/3 of tongue

Patient cannot stop producing saliva

Patient is unable to taste his favorite cake with anterior 2/3 of tongue

Patient is unable to move 1 side of his/her face

also decreased salivation (SM and SL)

Explanation

also decreased salivation (SM and SL)

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About This Quiz

This quiz focuses on the anatomy of cranial nerves, assessing knowledge in nerve functions and pathologies affecting jaw movement, taste sensation, and somatic sensation. It is designed for... see moremedical students preparing for practical exams and rotations, enhancing diagnostic skills related to nerve injuries. see less

2. After having a few cervical lymph nodes biopsied, a patient has reduced ability to flex his head to the left or turn his head to the right. Which of the following structures was most likely damaged?

CN XI

Phrenic Nerve

CN X

Superior Trunk of Brachial Plexus

Dorsal Scapular Nerve

SCM rotates head contralaterally and assists in ipsilateral lateral flexion (w/ scalenes)

Explanation

SCM rotates head contralaterally and assists in ipsilateral lateral flexion (w/ scalenes)

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3. Patient comes to your office complaining of inability to extend at the wrist, you suspect compressed brachial plexus. Which of the following could cause his symptoms?

Hypertension

Horner's syndrome

Brain tumor

Co-arctation of the aorta

Pancoast tumor

growing mass in apex of lung can cause various brachial plexopathies

Explanation

growing mass in apex of lung can cause various brachial plexopathies

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4. A patient is unable to taste a piece of sugar placed on the tip of the tongue. Which nerve is most likely to have a lesion?

Facial nerve

Glossopharyngeal nerve

Hypoglossal nerve

Trigeminal nerve

Vagus nerve

receives SVA from anterior 2/3 of tongue.

Explanation

receives SVA from anterior 2/3 of tongue.

Submit

5. A young girl complains of dryness of the nose, palate, and eye. This would indicate a lesion to which of the following ganglia?

Nodose ganglion

Otic ganglion

Pterygopalatine ganglion

Submandibular ganglion

Ciliary gangion

post ganglionic fibers from PPG provide GVE to Lacrimal, Nasal mucosal, and Minor Palatine Salivary glands.

Explanation

post ganglionic fibers from PPG provide GVE to Lacrimal, Nasal mucosal, and Minor Palatine Salivary glands.

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6. Damage to the lingual nerve right before it is joined by the chorda tympani nerve would result in a loss of which of the following:

Loss of somatic sensation to the posterior 2/3 of the tongue

Loss of parasympathetic innervation to the submandibular/sublingual gland

Loss of parasympathetic innervation to the submandibular/sublingual gland AND taste to the anterior 2/3 of the tongue

Loss of taste AND somatic sensation to the anterior 2/3 of the tongue

Loss of somatic sensation to the anterior 2/3 of the tongue

The lingual nerve itself (branch of CN V.3) only carries somatic sensation (GSA) to the anterior 2/3 of the tongue. The Chorda Tympani nerve (branch of Cranial nerve VII) provides PSNS innervation (GVE) to the SM/SL glands, as well as taste (SVA) to the anterior 2/3 of the tongue. If the lingual nerve is damaged AFTER it is joined by chorda tympani, a loss of all 3 modalities will be seen.

Explanation

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7. One of many potential symptoms of Bell's Palsy is hyperacousia. Which nerve and its associated muscle is damaged in hyperacousia?

CN V ; stapedius

CN VII ; tensor tympani

CN VII ; stapedius

CN V ; tensor veli palatini

the lesion would have to be proximal to the nerve to stapedius. Tensor tympani is innervated by V.3.

Explanation

the lesion would have to be proximal to the nerve to stapedius. Tensor tympani is innervated by V.3.

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8. An elderly man comes to see you in your office about large quantities of ear wax that have built up in his ears. You decide to clean the wax out, and while you are dislodging the ear wax for him, he starts to tell you that he is feeling faint and dizzy. His symptoms are a result of:

His age

Stimulation to his inner tympanic membrane eliciting a vagus response

Stimulation to his external auditory canal eliciting a vagus response

Pain from the procedure eliciting a vagus response

wax builds up in external auditory canal which is partially innervated by CN X. Inner side of tympanic membrane is innervated by CN IX.

Explanation

wax builds up in external auditory canal which is partially innervated by CN X. Inner side of tympanic membrane is innervated by CN IX.

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9. A patient comes to you complaining of not being able to eat. On exam, you notice that she is having difficulty protracting her jaw. What muscle is most likely affected?

Medial pterygoid

Lateral pterygoid

Temporalis

Masseter

Mylohyoid

the fibers are nearly horizontal, so when they contract they pull the head of the mandible anteriorly

Explanation

the fibers are nearly horizontal, so when they contract they pull the head of the mandible anteriorly

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10. During a pathology rotation the attending physician points to a nerve as it crosses behind the body of the mandible and asks your class, "what nerve modalities are running in this part of the lingual nerve?" You confidently respond:

GSE and GVE

GSA and GVE

SVA, GVE and GSA

GVE, SVA and GSE

GSE and SSA

picks up GVE and SVA fibers from chorda tympani.

Explanation

picks up GVE and SVA fibers from chorda tympani.

Submit

11. A 46-year-old man visits the speech therapist complaining of dryness of the mouth. The therapist performs a swallowing study and, on examination, finds that the man has a lack of salivary secretion from the submandibular gland. This indicates a lesion of which of the following nervous structures?

Lingual nerve at its origin

Chorda tympani in the middle ear cavity

Superior cervical ganglion

Lesser petrosal nerve

Auriculotemporal nerve

carries preganglionic GVE to join with lingual nerve distal to its origin.

Explanation

carries preganglionic GVE to join with lingual nerve distal to its origin.

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12. A small lesion has damaged the vagus nerve proximal to its pharyngeal branches. Which muscle would still be functional?

Superior pharyngeal constrictors

Stylopharyngous

Middle Pharyngeal constrictors

Levator palitini

Only muscle innervated by CN IX

Explanation

Only muscle innervated by CN IX

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13. For his operation, Ned is given Ketamine as an adjunct to his general anesthesia. Adverse effects include post-operative delusions and vivid hallucinations. Currently, Ned believes he is a tiny person living inside a giant middle ear. If he looks out his bedroom window, which has a glorious view of the medial wall, what structures will he see (assuming Ned's hallucinations are anatomically correct)?

Canal for tensor tympani, mastoid air sinus, tympanic membrane

Oval window, round window, tympanic plexus

Oval window, tympanic membrane, chorda tympani nerve

Tympanic plexus, round window, canal for tensor tympani

The story is false, but the adverse effects of Ketamine are true. The labrynthine wall has prominences of lateral semicircular canal and facial canal, round and oval windows, and the tympanic plexus over the promontory.

Explanation

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14. Ned walks in to his 4^th semester ICM practical exam to find that his standardized patient is Richard Kiel, the 7-foot actor who played Jaws in The Spy Who Loved Me and (possibly more notably) Mr. Larson in Happy Gilmore. Ned's task is to examine the trigeminal and facial nerves. After washing his hands, greeting the patient, and inspecting the patient's face, Ned asks Mr. Kiel to clench his jaws. This joke makes Ned giggle, but he's able to palpate bilateral contractions of the appropriate muscles. Next, he instructs Mr. Kiel to open his mouth and move his mandible side to side. What muscle is Ned primarily testing with this last maneuver?

Medial Pterygoid

Lateral Pterygoid

Masseter

Sternocleidomastoid

The orientation of the lateral pterygoid muscle is nearly horizontal from the lateral side of the sphenoid bone to the medial side of the neck of the mandible. Contracting bilaterally the mandible protrudes, acting unilaterally and alternately the mandible moves side to side.

Explanation

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15. To relieve Raynaud's syndrome in your patient, where do you anesthetize?

Vagus nerve

Internal carotid artery

Stellate ganglion

Sympathetic trunk

that’s one way to perform a sympathectomy. D would also cause Horner’s syndrome, which is bad.

Explanation

that’s one way to perform a sympathectomy. D would also cause Horner’s syndrome, which is bad.

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16. The chorda tympani nerve contains which of the following fibers?

SSA to anterior 2/3 of tongue

Postganglionic sympathetic

SVA to posterior 1/3 of tongue

Preganglionic parasympathetic

Postganglionic parasympathetic

remember SSA is Audio-visual, and SVA is olfaction and gestation.

Explanation

remember SSA is Audio-visual, and SVA is olfaction and gestation.

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17. A 45-year-old woman is suffering from numbness just anterior to her left ear. Which of the following nerves is most likely to be damaged?

Ophthalmic division of Trigeminal nerve

Maxillary division of Trigeminal nerve

Mandibular division of Trigeminal nerve

Facial nerve

auriculotemporal nerve from V.3 provides cutaneous sensation to this area.

Explanation

auriculotemporal nerve from V.3 provides cutaneous sensation to this area.

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18. Which of the following muscles retracts the mandible?

horizontal fibers of temporalis muscle retract the mandible.

Explanation

horizontal fibers of temporalis muscle retract the mandible.

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19. A 35 year old extremely wealthy and successful Alto singer from California comes to your walk-in clinic claiming that she can no longer sing and appears to be very distraught. Recent PMH shows that she had a thyroglossal duct cyst surgically removed 2 weeks ago. You notice that the surgical incision was made below the level of the thyroid cartilage and was slightly lateral to the mid-line of the neck. Which nerve was most likely damaged during this patient's previous surgery that caused her chief complaint?

There was no surgical complication; the patient is malingering in hopes of gaining a quick buck via lawsuit.

Inferior laryngeal nerve

Internal laryngeal nerve

Nerve to mylohyoid

External laryngeal nerve

The external laryngeal nerve innervates the cricothyroid muscle. The cricothyroid muscle tenses the vocal cords, allowing for high pitch phonation which is essential for the Alto voice. Answer choice A is disputable, but considering that the patient is extremely wealthy, she would probably be less driven to malinger for a small personal gain (Also: Why would you pick a behavioral answer for an Anatomy Question? that's just silly).

Explanation

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