Block 5 Anatomy Wk 3 From Ta's W Exp
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- 1.
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?
- A.
Medial pterygoid
- B.
Lateral pterygoid
- C.
Temporalis
- D.
Masseter
- E.
Mylohyoid
Correct Answer
B. Lateral pterygoidExplanation
the fibers are nearly horizontal, so when they contract they pull the head of the mandible anteriorlyRate this question:
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- 2.
The chorda tympani nerve contains which of the following fibers?
- A.
SSA to anterior 2/3 of tongue
- B.
Postganglionic sympathetic
- C.
SVA to posterior 1/3 of tongue
- D.
Preganglionic parasympathetic
- E.
Postganglionic parasympathetic
Correct Answer
D. Preganglionic parasympatheticExplanation
remember SSA is Audio-visual, and SVA is olfaction and gestation.Rate this question:
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- 3.
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:
- A.
GSE and GVE
- B.
GSA and GVE
- C.
SVA, GVE and GSA
- D.
GVE, SVA and GSE
- E.
GSE and SSA
Correct Answer
C. SVA, GVE and GSAExplanation
picks up GVE and SVA fibers from chorda tympani.Rate this question:
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- 4.
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:
- A.
Loss of somatic sensation to the posterior 2/3 of the tongue
- B.
Loss of parasympathetic innervation to the submandibular/sublingual gland
- C.
Loss of parasympathetic innervation to the submandibular/sublingual gland AND taste to the anterior 2/3 of the tongue
- D.
Loss of taste AND somatic sensation to the anterior 2/3 of the tongue
- E.
Loss of somatic sensation to the anterior 2/3 of the tongue
Correct Answer
E. Loss of somatic sensation to the anterior 2/3 of the tongueExplanation
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.Rate this question:
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- 5.
A lesion to the chorda tympani nerve would cause what clinical sign?
- A.
Patient complaining of swollen cheek
- B.
Patient complaining of loss of somatic sensation to anterior 2/3 of tongue
- C.
Patient cannot stop producing saliva
- D.
Patient is unable to taste his favorite cake with anterior 2/3 of tongue
- E.
Patient is unable to move 1 side of his/her face
Correct Answer
D. Patient is unable to taste his favorite cake with anterior 2/3 of tongueExplanation
also decreased salivation (SM and SL)Rate this question:
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- 6.
A small lesion has damaged the vagus nerve proximal to its pharyngeal branches. Which muscle would still be functional?
- A.
Superior pharyngeal constrictors
- B.
Stylopharyngous
- C.
Middle Pharyngeal constrictors
- D.
Levator palitini
Correct Answer
B. StylopharyngousExplanation
Only muscle innervated by CN IXRate this question:
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- 7.
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:
- A.
His age
- B.
Stimulation to his inner tympanic membrane eliciting a vagus response
- C.
Stimulation to his external auditory canal eliciting a vagus response
- D.
Pain from the procedure eliciting a vagus response
Correct Answer
C. Stimulation to his external auditory canal eliciting a vagus responseExplanation
wax builds up in external auditory canal which is partially innervated by CN X. Inner side of tympanic membrane is innervated by CN IX.Rate this question:
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- 8.
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?
- A.
Hypertension
- B.
Horner's syndrome
- C.
Brain tumor
- D.
Co-arctation of the aorta
- E.
Pancoast tumor
Correct Answer
E. Pancoast tumorExplanation
growing mass in apex of lung can cause various brachial plexopathiesRate this question:
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- 9.
One of many potential symptoms of Bell's Palsy is hyperacousia. Which nerve and its associated muscle is damaged in hyperacousia?
- A.
CN V ; stapedius
- B.
CN VII ; tensor tympani
- C.
CN VII ; stapedius
- D.
CN V ; tensor veli palatini
Correct Answer
C. CN VII ; stapediusExplanation
the lesion would have to be proximal to the nerve to stapedius. Tensor tympani is innervated by V.3.Rate this question:
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- 10.
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)?
- A.
Canal for tensor tympani, mastoid air sinus, tympanic membrane
- B.
Oval window, round window, tympanic plexus
- C.
Oval window, tympanic membrane, chorda tympani nerve
- D.
Tympanic plexus, round window, canal for tensor tympani
Correct Answer
B. Oval window, round window, tympanic plexusExplanation
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.Rate this question:
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- 11.
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?
- A.
Ophthalmic division of Trigeminal nerve
- B.
Maxillary division of Trigeminal nerve
- C.
Mandibular division of Trigeminal nerve
- D.
Facial nerve
Correct Answer
C. Mandibular division of Trigeminal nerveExplanation
auriculotemporal nerve from V.3 provides cutaneous sensation to this area.Rate this question:
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- 12.
A young girl complains of dryness of the nose, palate, and eye. This would indicate a lesion to which of the following ganglia?
- A.
Nodose ganglion
- B.
Otic ganglion
- C.
Pterygopalatine ganglion
- D.
Submandibular ganglion
- E.
Ciliary gangion
Correct Answer
C. Pterygopalatine ganglionExplanation
post ganglionic fibers from PPG provide GVE to Lacrimal, Nasal mucosal, and Minor Palatine Salivary glands.Rate this question:
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- 13.
To relieve Raynaud’s syndrome in your patient, where do you anesthetize?
- A.
Vagus nerve
- B.
Internal carotid artery
- C.
Stellate ganglion
- D.
Sympathetic trunk
Correct Answer
C. Stellate ganglionExplanation
that’s one way to perform a sympathectomy. D would also cause Horner’s syndrome, which is bad.Rate this question:
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- 14.
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?
- A.
CN XI
- B.
Phrenic Nerve
- C.
CN X
- D.
Superior Trunk of Brachial Plexus
- E.
Dorsal Scapular Nerve
Correct Answer
A. CN XIExplanation
SCM rotates head contralaterally and assists in ipsilateral lateral flexion (w/ scalenes)Rate this question:
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- 15.
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?
- A.
Facial nerve
- B.
Glossopharyngeal nerve
- C.
Hypoglossal nerve
- D.
Trigeminal nerve
- E.
Vagus nerve
Correct Answer
A. Facial nerveExplanation
receives SVA from anterior 2/3 of tongue.Rate this question:
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- 16.
Ned walks in to his 4th 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?
- A.
Medial Pterygoid
- B.
Lateral Pterygoid
- C.
Masseter
- D.
Sternocleidomastoid
Correct Answer
B. Lateral PterygoidExplanation
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.Rate this question:
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- 17.
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?
- A.
There was no surgical complication; the patient is malingering in hopes of gaining a quick buck via lawsuit.
- B.
Inferior laryngeal nerve
- C.
Internal laryngeal nerve
- D.
Nerve to mylohyoid
- E.
External laryngeal nerve
Correct Answer
E. External laryngeal nerveExplanation
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).Rate this question:
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- 18.
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?
- A.
Lingual nerve at its origin
- B.
Chorda tympani in the middle ear cavity
- C.
Superior cervical ganglion
- D.
Lesser petrosal nerve
- E.
Auriculotemporal nerve
Correct Answer
B. Chorda tympani in the middle ear cavityExplanation
carries preganglionic GVE to join with lingual nerve distal to its origin.Rate this question:
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- 19.
Which of the following muscles retracts the mandible?
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
A. AExplanation
horizontal fibers of temporalis muscle retract the mandible.Rate this question:
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Mar 21, 2023Quiz Edited by
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Feb 11, 2012Quiz Created by
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