Block 5 Anatomy Wk 4 From Ta's W Exp

Medicine

Anatomy

Neurology

USMLE

NBME

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Chachelly

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| Attempts: 142 | Questions: 16

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1. A five year old boy is found to have a pericardial infection. Upon imaging studies the source of the infection is identified within an esophageal diverticulum. What is the route the infection spread through?

Retropharyngeal space

Vertebral bodies

Loose connective tissue of the skin

Jugular veins

Tonsillar lymphatics

retropharyngeal space extends from the base of the skull down to the mediastinum.

Explanation

retropharyngeal space extends from the base of the skull down to the mediastinum.

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About This Quiz

Block 5 Anatomy Wk 4 From Tas W Exp - Quiz

Explore the intricate functions of nerves in medical scenarios. This quiz assesses knowledge on nerve impact in various anatomical contexts, focusing on practical applications like managing pain, understanding blood flow, and nerve synapses relevant for medical students and professionals.

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2. A child is brought to the emergency room after swallowing a dime. The mother is concerned about the location of the dime. After an X-ray of the neck, the dime can be seen located in the neck. The boy has no difficulty breathing and is able to talk clearly. Which of the following is the most likely place the dime will be stuck?

Piriform Recess

Esophagus

Trachea

Vocal Cords

the body’s piggy bank.

Explanation

the body’s piggy bank.

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3. A 26-year-old singer visits her physician, an ear, nose, and throat (ENT) surgeon, and complains of changes in her voice. A laryngoscopic examination demonstrates a lesion of the superior laryngeal nerve, causing weakness of which of the following muscles?

Cricothyroid

Middle pharyngeal constrictor

Thyroarytenoid

Thyrohyoid

innervated by external branch of Superior Laryngeal Nerve

Explanation

innervated by external branch of Superior Laryngeal Nerve

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4. Your friend goes to a concert and comes home early complaining that the noise, which he can normally tolerate, was just too loud. On exam, you notice that he has some weakness to his muscles of facial expression. Which muscle is most likely implicated in his hyperacusis?

Mylohoid

Tensor tympani

Diagastric, Posterior Belly

Buccinator

Stapedius

innervated by CN VII

Explanation

innervated by CN VII

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5. A patient comes to your office complaining of right lower jaw pain. Upon inspection of the mouth, you find an abscess on the 2^nd right mandibular molar. What nerve could you anesthetize to relieve the pain?

Greater palatine nerve

Lesser palatine nerve

Superior alveolar nerve

Inferior alveolar nerve

Nasopalatine nerve

Key word is mandibular

Explanation

Key word is mandibular

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6. A 15 year old boy falls from his bicycle and hits his head. His initial examination in the ER is normal, but later in the day, he becomes noticeably lethargic. He is brought back to the ER where he is too drowsy to answer the examiner's questions. His right pupil is 7mm and his left is 4mm. Patellar tendon reflexes are brisker on the left, and a Babinski sign can be elicited on the left. CT imaging reveals that a pool of blood has displaced the right temporal lobe to the left. The hematoma is evacuated, and a blood vessel is cauterized. Through which opening did the lacerated blood vessel enter the cranial cavity?

Foramen Spinosum

Stylomastoid Foramen

Foramen lacerum

Carotid Canal

Jugular Foramen

Middle Meningeal Artery rupture causes epidural hematoma.

Explanation

Middle Meningeal Artery rupture causes epidural hematoma.

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7. Davis, an AMSA member and second semester medical student, shadows a tonsillectomy. During the procedure, the surgeon asks the group of Ross AMSA members to name the two arches that border the Palatine Tonsils. Davis enthusiastically replies with the correct answer:

Anterior Tonsillar Arch & Posterior Tonsillar Arch

Palatoglossal Arch (Anteriorly) & Palatopharyngeal Arch (Posteriorly)

Palatopharyngeal Arch (Anteriorly) & Palatoglossal Arch (Posteriorly)

Torus Tubarius (Anteriorly) & Salpingopharyngeal fold (Posteriorly)

Palatoglossal folds (Anteriorly) & Salpingopharyngeal fold (Posteriorly)

The Palatoglossal Arch is anterior to the palatine tonsil and the Palatopharyngeal Arch is posterior to the palatine tonsil. Answer choice A simply doesn't exist. Answer C has incorrect spacial relationships. Answer D contains structures that are found further posterior and superior in the naso/oropharynx (See Nasal Cavity Lecture). Answer E is only half correct.

Explanation

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8. What nerve fibers synapse in the pterygopalatine ganglion?

GVA Sympathetic fibers of the Nerve to the Pterygoid canal

GVE Sympathetic fibers the Greater Petrosal nerve

GVE Parasympathetic fibers of the Oculomotor Nerve

GVE Parasympathetic fibers of the Nerve of the Pterygoid canal

GVA Parasympathetic fibers of the Nerve of the Pterygoid canal

Greater Petrosal Nerve (VII) joins with Deep Petrosal Nerve (SNS) to form Nerve of the Pterygoid Canal which carries GVE (PSNS and SNS), GVA, and SVA (from palate). Only PSNS GVE synapse in PPG.

Explanation

Greater Petrosal Nerve (VII) joins with Deep Petrosal Nerve (SNS) to form Nerve of the Pterygoid Canal which carries GVE (PSNS and SNS), GVA, and SVA (from palate). Only PSNS GVE synapse in PPG.

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9. A patient has been complaining of tooth pain in his upper jaw for the past 2 weeks. Upon doing a full interview, you learn that your patient was born with a congenital condition known as situs inversus. He also has karatgener's syndrome and is infertile. He says his whole head feels heavy, his face hurts, and he has been somewhat congested as well. As a recent Ross graduate, you know that the upper row of teeth is innervated by the superior alveolar nerve, a branch of the maxillary nerve, but you recall your Anatomy Professors warning you differentiate face and tooth pain from something else. Given the history of the patient, what is he most likely suffering from?

Damage to Internal Nasal Nerve

Damage to Lesser Palatine nerve

Infection of Sphenoidal sinus

Infection of the Maxillary sinus

Damage to the Greater Palatine Nerve

The history of this patient suggests that he has immotile ciliary syndrome (given his situs inversus, kartagener's and infertility). Drainage of the paranasal sinuses is also dependent on the function of cilia. Hence people with impaired ciliary function, including smokers, are more susceptible to sinusitis due to impaired drainage of the sinuses. In this case, the maxillary sinus is infected. It's proximity to the upper row of teeth (superior alveolar nerve), and the orbit (inferior orbital nerve) is noteworthy. Infection of the maxillary sinus often presents with face and tooth face.

Explanation

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10. What bone forms the concha that overlies the meatus where the maxillary sinus drains?

Ethmoid

Nasal

Sphenoid

Vomer

None, it's cartilage

: Maxillary sinus drains to middle meatus which is covered by the middle concha from the ethmoid bone.

Explanation

: Maxillary sinus drains to middle meatus which is covered by the middle concha from the ethmoid bone.

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11. While on a bus traveling north from Leticia in the Colombian Amazon you encounter a woman who asks you for your saliva. At first this seems a little strange but later you learn that she wants to use it to produce her home-made chicha beverage that requires salivary amylase to allow the bacteria to ferment the sugars in the maize and mandioca. You agree and she begins massaging on the sides of your jaw in order to increase blood flow to your sublingual and submandibular glands. To increase blood flow to both of these glands she wants to stimulate blood flow from which artery?

Inferior alveolar artery

Facial Artery

Lingual artery

Sphenopalatine Artery

Facial artery - facial artery gives off the submental artery that according to Dr. Dhiman's oral cavity lecture supplies both sublingual and submandibular glands. Lingual artery supplies bloodflow to the sublingual gland but not to the submandibular.

Explanation

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12. Matt Hasselback retaliates on Ned by punching him in the right eye. Ned suffers a blowout fracture resulting in herniation of orbital soft tissues into one of his paranasal sinuses. On the below MRI, which arrow indicates the most likely area of herniation?

blow-out fracture refers to fracturing the orbital floor, so soft tissue may herniate into the maxillary sinus.

Explanation

blow-out fracture refers to fracturing the orbital floor, so soft tissue may herniate into the maxillary sinus.

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13. Ned despises Pro-quarterback Matt Hasselback so much that he punches him in the nose. Since you're a caring medical student with a wealth of anatomy knowledge, you help him stop the epistaxis by applying pressure to Kiesselbach's area. This area receives blood from which branch(es) of the external carotid artery?

Ophthalmic

Maxillary

Facial

B&C

All of the Above

Ophtalmic Artery contributes blood to the anastamosis but it’s a branch of the internal carotid artery.

Explanation

Ophtalmic Artery contributes blood to the anastamosis but it’s a branch of the internal carotid artery.

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14. As your friend is traveling the plains of northern Wyoming in early June, he encounters an old injun who prides himself in collecting teeth from the white men. However, due to his belief in the Moon Man taking vengeance on those who cause pain he injects his homeprep of nerve block to remove the upper premolars bilaterally. In what nerve(s) would he like to inject the nerve block to inhibit pain sensation from the periodontal ligament, teeth or alveolar process?

Buccal branch of Lingual

Infraorbital nerve just above the canine fossa

Greater Palatine Nerve before it leaves the Greater palatine foramen

Just as the nasopalatine leaves the incisor foramen

Maxillary Nerve after the Pterygopalatine ganglion

The superior dental plexus (for the premolars mostly the middle superior alveolar nerves) begins to receive its contributions after V2 passes the pterygopalatine ganglion. The buccal branch supplies the buccal gingiva. The infraorbital might supply a little of the gingiva in the maxillary teeth. Greater palatine nerve does sensation to hard palate

Explanation

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15. An infant has bilateral cleft lip. Which processes failed to fuse?

Lateral nasal prominences with the maxillary prominences

Maxillary prominences with the intermaxillary segments

Palatine shelves from each maxillary prominence

Medial nasal prominences from each side

Frontonasal prominence with each maxillary prominence

B/L cleft lip

Explanation

B/L cleft lip

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16. Due to his love for the Backstreet Boys, Paul hyperventilates every time a song comes on. After spending months listening to them, what clinical syndrome is he likely to have?

Metabolic alkalosis

Atelectasis

Thoracic outlet syndrome

Horner’s

Metabolic acidosis

habitual hyperventilation can lead to hypertrophy of the accessory muscles of respiration including the anterior and middle scalenes which can compress the brachial plexus and/or subclavian artery. Hyperventilation does cause respiratory alkalosis which will be compensated by healthy kidneys (but not to the point of acidosis).

Explanation

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