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?

ptosis on the left side that disappears on upward gaze

profound ptosis on the left side

gustatory sweating over the left parotid gland

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?

Inability to laterally rotate upper limb

Inability to pronate the forearm

Inability to supinate the forearm

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:

Between the two heads of the right sternocleidomastoid muscle

At the sternal angle on the right side

Lateral to the sternocleidomastoid muscle on the right side

Between the bellies of the anterior and middle scalene muscles on the right side

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

Ventral rami of spinal nerves C1-C2

Ventral rami of spinal nerves C4-C6

Dorsal rami of spinal nerves C2-C4

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

Muscles enclosed in the visceral layer of pretracheal fascia

Muscles enclosed in the deep investing fascia of the neck

Muscles enclosed in prevertebral fascia

Muscles enclosed in deep investing fascia and pretracheal visceral fascia

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

10 Questions | By BLACKMD | Updated: Mar 14, 2022 | Attempts: 32

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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?
- Carotid canal
- Foramen magnum
- Foramen lacerum
- Jugular foramen
- Foramen ovale

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?
- Ptosis on the left side that disappears on upward gaze
- Profound ptosis on the left side
- Dry eye on the left side
- Gustatory sweating over the left parotid gland
- Dry mouth
Correct Answer

A. Dry mouth
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?
- Inability to abduct upper limb
- Inability to laterally rotate upper limb
- Inability to pronate the forearm
- Inability to supinate the forearm
- Inability to abduct the thumb
Correct Answer

A. Inability to abduct the thumb
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?
- Ansa cervicalis
- Oculomotor nerve (CN III)
- Ophthalmic nerve (CNVl)
- Optic nerve (CNII)
- Ansa subclavia
Correct Answer

A. Ansa cervicalis
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 :
- External jugular vein
- Parietal pleura
- Subclavian artery
- Phrenic nerve
- Vagus nerve
Correct Answer

A. Phrenic nerve
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:
- Between the two heads of the right sternocleidomastoid muscle
- Jugular notch
- At the sternal angle on the right side
- Lateral to the sternocleidomastoid muscle on the right side
- Between the bellies of the anterior and middle scalene muscles on the right side
Correct Answer

A. Between the two heads of the right sternocleidomastoid muscle
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?
- Subclavian vein
- Internal jugular vein
- Axillary vein
- External jugular vein
- Anterior jugular vein
Correct Answer

A. Anterior jugular vein
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?
- Common carotid artery
- Ansa cervicalis
- Vagus nerve
- Hypoglossal nerve
- Trunks of the brachial plexus
Correct Answer

A. Ansa cervicalis
9.

The anterior scaIene muscle is an important accessory muscle of respiration. Its innervation is:
- Ventral rami of spinal nerves C1-C2
- Ventral rami of spinal nerves C4-C6
- Dorsal rami of spinal nerves C2-C4
- Brachial plexus
- Phrenic nerve
Correct Answer

A. Brachial plexus
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
- Muscles enclosed in the deep investing fascia of the neck
- Muscles enclosed in the visceral layer of pretracheal fascia
- Muscles enclosed in prevertebral fascia
- Muscles enclosed in deep investing fascia and pretracheal visceral fascia
- All of the above
Correct Answer

A. Muscles enclosed in the visceral layer of pretracheal fascia

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Quiz Edited by
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Jan 24, 2012

Quiz Created by
BLACKMD

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

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?

Quiz Preview

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?

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:

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?

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

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