Semester 2 Neuro, Quiz 11 - Root And Triangles Of The Neck

1. A student was shot by a bullet in the left side of the neck. The wound left him bleeding profusely and paralyzed the sternomastoid, trapezius and stylopharyngeus muscles on the same side. The posterior third of the tongue lost taste sensation. The bullet had pierced which of the following sites?

2. An 18-year-old male presented to the Emergency Room bleeding profusely from a deep cut in the left occipital triangle of his neck and undergoes emergency surgery to repair his internal jugular vein. He survives his injury but he is found on neurological examination to have left-sided weakness in shrugging his shoulder, cannot turn his head to the left against resistance, has a flat left soft palatal arch, and lacks a gag reflex on the left side. What additional clinical sign would be expected in this patient?

3. A young mountain climber falls 20 feet before grasping a tree root. He injures the lower trunk of the brachial plexus. Which of the following signs or symptoms might you expect to find?

4. This patient is a 33-year-old woman with a 17-pack-year history of smoking. She presents with a mild right-sided ptosis, constricted pupil (miosis), and decreased sweating on the right side of her face. She is diagnosed with a tumor in the apex of her right lung at the root of the neck. Damage to what anatomical structure explains her symptoms?

5. A 25-year old male patient presents with a sharp knife-stab on the right side of the neck about 3 cm superior to the clavicle after a pub fight. Observing the patient, the ER resident finds dispnoe as the major symptom. An emergency chest x-ray shows a normal lung image. The resident suspects the injury of one of following structures :

6. A resident is attempting her first placement of central line into the right internal jugular vein. To correctly locate the point of insertion, she should place the needle at the:

7. You are called on to do a venous catheterization to measure central venous pressure in the heart. You insert the catheter using the indentation between the two inserting heads of the right sternocleidomastoid muscle as a landmark. Which vessel is the target of this procedure?

8. Your 30-year-old patient has a lower neck injury. During the physical examination you realize that the wound is in the omoclavicular triangle. You know that this injury might be dangerous because important structures are passing through this area. Which of the following structures might be in danger?

9. The anterior scaIene muscle is an important accessory muscle of respiration. Its innervation is:

10. A victim of a motor vehicle accident suffers a cranial base fracture that extends through the jugular foramen and damages the nerves that exit here. Motor deficits in the neck that this patient will evince include weakness or paralysis of