Anatomy Unit 2 scalp and face/cranial cavity/orbit/ear/triangles/infratemporal fossa/external pharynx/nasal cavity/larynx/pharynx/palate

Chorda tympani originates from what cranial nerve CN III CN VII CN IX CN X CN V

CN VII (facial)

Choose the appropriate lettered structure in this MRI scan (see figure) showing a sagittal section through the head and neck. Tears drain through the nasolacrimal duct into the space below which structure? A B C D E

B (the inferior meatus)

An MRI of the right internal carotid artery reveals atherosclerotic plaques causing stenosis of the vessel's lumen within the cavernous sinus. The stenosis is causing increased pressure within the internal carotid artery as it courses through the cavernous sinus, resulting in an aneurysm. Given its location, what cranial nerve would most likely be damaged?

abducent nerve

A large bone spur is impinging on structures in the foramen magnum, which of the following will be most affected?

ability to shrug the shoulders

A 33-year-old woman develops Bell's palsy. She must be cautious because this can result in corneal inflammation and subsequent ulceration. This symptom results from which of the following conditions? Sensory loss of the cornea and conjunctiva Absence of the corneal blink reflex Absence of sweating on the face Inability to constrict the pupil Lack of secretion of the parotid gland

absence of the corneal blink reflex

A 42-year-old man has a lymph node biopsy in the left side of his lateral cervical region or posterior triangle of his neck. After closure of the wound, the physician asks the patient to rotate his head to the right against resistance, as shown in the photo. What nerve is the doctor assessing with this test? Accessory Mandibular division of trigeminal Upper trunk of the brachial plexus Hypoglossal Great auricular

spinal accessory

A 31-year-old woman complains of headache and dizziness after hitting a kitchen cabinet door with her head. Her MRI scan and venogram show a large blood clot in the great cerebral vein of Galen. The obstructed vein of the brain is a direct tributary of which of the following venous structures? Pterygoid venous plexus Emissary veins Internal jugular vein Diploic veins Dural venous sinuses

dural venous sinuses

A dentist prepares for an extraction of the second mandibular molar. To anesthetize the tooth, she injects a local anesthetic to block the mandibular division of the trigeminal nerve as it leaves the skull. What skull foramen is she targeting? Foramen ovale Foramen magnum Foramen rotundum Superior orbital fissure Jugular foramen

foramen ovale

A 34-year-old man visits his physician complaining of abnormal sensations and numbness in his upper teeth and in the skin of his lower eyelid, cheek, upper lip, and lateral external nose on his left side. Which of the following cranial openings is the most likely site for the nerve lesion responsible for these signs and symptoms?

foramen rotundum the maxillary division of the trigeminal nerve (V2) supplies sensation to this area of the face and it goes through the foramen rotundum

You are working in the ED and a patient is brought in by ambulance after an attempted strangulation. Once vital signs are established to be near normal, you are most likely concerned about which of the following conditions? Dislocated axis Fractured thyroid cartilage Fractured axis Fractured hyoid bone Severed epiglottis

fractured hyoid bone

A kick fighter is brought into the locker room after being knocked out by his opponent. He has suffered severe trauma to the articular disk and capsule of the temporomandibular joint. This could result in paralysis of which of the following muscles? Lateral pterygoid Buccinator Temporalis Masseter Medial pterygoid

lateral pterygoid

A 23-year-old man has an impacted left third mandibular molar (or wisdom) tooth extracted. Following the surgery, the patient reports numbness in the anterior aspect of his tongue. Which of the following nerves is damaged? Inferior alveolar nerve Chorda tympani nerve Mylohyoid nerve Glossopharyngeal nerve Lingual nerve

lingual nerve

You are assisting an oral surgeon who is about to remove a calculus (stone) from a patient's submandibular duct. The surgeon asks you to remind him what nerve he has to be careful not to injure while incising the duct directly under the floor of the mouth. What is your reply? Chorda tympani Glossopharyngeal Internal laryngeal Spinal accessory Lingual

lingual nerve

The muscle that indents the submandibular gland and divides it into superficial and deep parts is paralyzed because of compression by a large salivary glandular tumor. Which of the following muscles is involved? Digastric posterior belly Stylohyoid Mylohyoid Styloglossus Hyoglossus

mylohyoid

What do the arrows in the above figure show?

normal fusion of sagittal suture

Which structure contains the postganglionic parasympathetic axons going to the ciliary muscle? Oculomotor nerve Nasociliary nerve Short ciliary nerve Ciliary ganglion

short ciliary nerve

Following a penetrated injury in the submandibular triangle, the tongue of a 45-year-old patient deviates to the left on protrusion. Which of the following nerves is injured? Left lingual nerve Right hypoglossal nerve Left hypoglossal nerve Left glossopharyngeal nerve Right lingual nerve

left hypoglossal nerve

A 54-year-old man comes to his doctor complaining of an inability to open his left eye. When he physically pries open his affected eye with his fingers (see photo), the gaze of his left eye is directed inferiorly and laterally, causing diplopia. His left pupil is also dilated in comparison to the right one. What nerve is most likely affected in this patient? Left trochlear nerve Left abducent nerve Left oculomotor nerve Right oculomotor nerve Right abducent nerve

left oculomotor nerve

A physician directs a small light into only the left eye of a patient to test pupillary constriction. The left pupil does not respond to the light; however, the right pupil constricts. What nerve is most likely damaged in this patient? Right oculomotor nerve Right optic nerve Left optic nerve Left oculomotor nerve Right ophthalmic nerve

left oculomotor nerve

A 3-year-old female child, whose mother described a difficult delivery, has a fixed head posture with the left ear tilted toward the left shoulder but the face turned to the right. Which of the following muscles was most likely damaged during birth and what is this condition called? Right trapezius, torticollis Left sternocleidomastoid, torticollis Right sternocleidomastoid, torticollis Left trapezius, torticollis Left trapezius, fibromastoiditis coli

left sternocleidomastoid, torticollis

After facial trauma, your patient has lost some sensation on the anterior aspect of his auricle and on a patch of skin about 2 cm wide from the anterior aspect of his auricle to pterion. A branch of which of the following nerves was damaged by the trauma?

lesser occipital

A 60-year-old man is unable to open his eye because of a rare neuromuscular disease. Which of the following muscles would most likely be paralyzed? Orbicularis oculi Superior rectus Orbicularis oris Levator palpebrae superioris Frontalis

levator palpebrae superioris

What muscle lies just inferior to the frontal nerve? Superior rectus Levator palpebrae superioris Lateral rectus Superior oblique

levator palpebrae superioris

Your 45-year-old patient complained of loss of sensation from the left side of his tongue following the extraction of an impacted left third molar. What was the nerve likely damaged by this procedure? Mental Inferior alveolar Lingual Masseteric Buccal

lingual

Being 'tongue-tied' refers to the presence of an overly large ________________. foramen cecum. terminal sulcus. lingual frenulum. submandibular duct. sublingual papilla.

lingual frenulum

A 75-year-old man tells his physician he has been having progressively more trouble opening his left eye because his upper eyelid tends to droop. Which of the following muscles is most likely weakened? Levator palpebrae superioris Orbicularis oculi Superior rectus Orbital muscle Frontalis

Levator palpebrae superioris

A patient asks you why her ears "pop" when she takes airplane trips. You explain that the feeling results from unequal pressure on the two sides of the tympanic membrane and is relieved by the action of two muscles that open the pharyngotympanic (Eustachian) tube. What are the two muscles? Salpingopharyngeus and stapedius Stapedius and tensor tympani Tensor tympani and tensor veli palatine Levator veli palatini and tensor veli palatini Levator veli palatine and stapedius

Levator veli palatini and tensor veli palatini

During a game, a 26-year-old baseball player is hit in the head by a baseball, which fractures the optic canal. Which of the following pairs of structures is most likely to be damaged? Ophthalmic artery and optic nerve Ophthalmic vein and ophthalmic nerve Optic nerve and ophthalmic vein Ophthalmic nerve and optic nerve Ophthalmic artery and ophthalmic vein

Ophthalmic artery and optic nerve

A 23-year-old man is suffering from numbness at the tip of his nose after being diagnosed with a brain tumor. Which of the following nerves is most likely being compressed by the tumor?

Ophthalmic division of the trigeminal nerve

A 45-year-old woman is suffering from numbness over the tip of her nose. Which of the following nerves is most likely to be damaged?

Ophthalmic division of the trigeminal nerve

When testing the sensory innervation of the face, a physician runs a cotton wisp along the skin of the tip of her patient's nose. If the patient can identify the location of the cotton wisp when her eyes are closed, what cranial nerve is intact and being tested by the doctor?

Ophthalmic division of the trigeminal nerve (V1)

Your 25-year-old patient sustained an injury to her neck that you think injured her spinal accessory nerve prior to it innervating the right sternocleidomastoid (SCM) muscle. You would most likely directly test the action of this muscle by asking your patient to do which of the following? Turn her head to the same side (chin turned to right) against resistance Turn her head to the opposite side (chin turned to left) against resistance Flex her head against resistance Flex her head to the left against resistance Extend her head against resistance

Turn her head to the opposite side (chin turned to left) against resistance

Choose the appropriate lettered structure in this radiograph of the lateral view of the head (see figure). A middle ear infection may spread into which structure? A B C D E

B (mastoid cells on side of head) Mastoid air cells communicate with the middle ear cavity through the antrum and aditus.

Choose the appropriate lettered structure in this MRI scan (see figure) showing a sagittal section through the head and neck. A lesion of the first cervical spinal nerve would cause functional impairment of which structure? A B C D E

C (hypoglossal affecting the tongue)

Choose the appropriate lettered structure in this MRI scan showing a transaxial section through the head (see figure). Which structure may be obliterated by a pituitary tumor?

C (suprasellar cistern) The suprasellar cistern can be obliterated by a pituitary tumor

What is the pterygoid hamulus? Cartilage Muscle Bony structure Tendon

bony structure

The parasympathetic fibers to the lacrimal gland originate with which cranial nerve? CN III Oculomotor CN VII Facial CN VI Abducens CN V Trigeminal

CN VII facial nerve

A 68-year-old man who had a severe cold became acutely ill about two weeks later. His wife consulted their family physician, who said to bring him to his office as soon as possible. During her examination the physician noted that he had a high fever, pain in his eyeballs, a severe headache, paranasal sinusitis, no pupillary reflex, and dilation of the pupil. She also noted that his right eyeball was abducted and directed slightly inferiorly. Which of the following statements best describes the most likely cause of the man's symptoms and signs?

Cavernous sinus thrombophlebitis involving the occulomotor nerve (CN III)

A 35-year-old woman comes to her dentist complaining of tenderness and pain in her cheek near the parotid gland, as well as bad breath and a foul-tasting mouth at meal times. A radiopaque fluid is injected into the parotid duct system through cannulation, and this sialography of the parotid duct confirms blockage by a calculus (sialolith). What muscle, through which the parotid duct passes, is most likely causing the stenosis where the sialolith now resides, blocking the drainage of the parotid duct?

buccinator

The arrow in the above coronal CT image points to a muscle that, if paralyzed, results in the cheek being bitten during mastication. What is this muscle? Masseter Lateral pterygoid Medial pterygoid Buccinator Temporalis

buccinator (the buccinator is labeled in the image)

Choose the appropriate lettered structure in this MRI scan (see figure) showing a sagittal section through the head and neck. Which structure runs along the line of attachment of the falx cerebri to the tentorium cerebelli?

D (straight sinus) The straight sinus runs along the line of the attachment of the falx cere-bri to the tentorium cerebelli, which supports the occipital lobe of the cerebrum and covers the cerebellum.

Which of the following labeled areas indicates the petrous portion of the temporal bone?

D: the petrous portion of the temporal bone The petrous portion of the temporal bone is a large wedge-shaped structure extending from the side of the skull toward the midline, forming much of the boundary between the middle and posterior cranial fossae. It is the densest bone in the body, being composed almost entirely of compact bone tissue.

An 8-year-old boy suffers a fracture at the base of the skull from the impact of a terrorist bomb explosion. The skull trauma includes a lesion of the vagus nerve. Damage at which of the indicated openings would injure the vagus nerve?

E (jugular foramen)

Choose the appropriate lettered structure in this radiograph of the lateral view of the head (see figure). Which structure would spread infection into the anterior part of the middle nasal meatus through the frontonasal duct?

E (the frontal sinus)

Your 75-year-old patient is having excessive tearing. You are asked to look at the above coronal CT and determine if there is any obstruction in the region where the nasolacrimal duct drains. You would look specifically at the region indicated by which letter? C E B D A

E (the inferior meatus)

A 59-year-old woman with pain at the side of her skull comes to the emergency department. An emergent head CT scan shows a large lesion in the internal auditory meatus. This condition may progress and damage which of the following pairs of structures?

Facial and vestibulocochlear nerves both go through the internal auditory meatus

A 37-year-old man feels a little discomfort when moving his tongue, pharynx, and larynx. Physical examination indicates that the muscles attached to the styloid process are paralyzed. Which of the following groups of cranial nerves are damaged? Facial, glossopharyngeal, and hypoglossal nerves Glossopharyngeal, trigeminal, and vagus nerves Vagus, spinal accessory, and hypoglossal nerves Hypoglossal, vagus, and facial nerves Facial, glossopharyngeal, and vagus nerves

Facial, glossopharyngeal, and hypoglossal nerves (posterior digastric: F, stylopharyngeus: G, styloglossus: H)

The somatic afferent fibers that innervate the cutaneous tissue of the posterior triangle reside within the epineurium of what nerve(s)? Mandibular nerve (V3) Ophthalmic nerve (V1) Spinal accessory nerve (CNXI) Cervical spinal nerves Maxillary nerve (V2)

cervical spinal nerves

A 33-year-old woman undergoes a stapedectomy (removal of the stapes) due to otosclerosis, or abnormal bone growth in the middle ear. Following the surgery, she complains that she has lost her sense of taste in the anterior part of the tongue. What nerve is most likely to have been iatrogenically injured during the surgical procedure? Mandibular branch of facial Inferior alveolar Chorda tympani Lingual Greater petrosal

chorda tympani

Your 40-year-old patient is complaining of an inability to securely close her right eye, eye pain and poor vision. She has no history of trauma. You diagnose her condition as Bell palsy, which typically involves inflammation of branches of which nerve?

facial nerve

A tumor is discovered embedded in the posterior wall of the tympanic cavity in a 45-year-old man. If the tumor erodes through this wall, which of the following structures will it first encounter? Internal jugular vein Tympanic membrane Brain Internal carotid artery Facial nerve

facial nerve (because it is posterior wall)

In examining a new born infant, you look for a sign of abnormal CSF pressure by doing which of the following?

feeling at the future site of bregma The anterior fontanelle is located at the future site of bregma, the junction of the sagittal and coronal sutures. The tension in the membrane at birth is a good indicator of abnormally increased or decreased CSF pressure.

A 3-year-old girl is admitted to the hospital with pain and hearing defect. An MRI examination reveals that she has developmental defects in the auditory tube and middle ear cavity. Which of the following pharyngeal pouches is most likely developed abnormally? Second and fourth pouches Fourth pouch Second pouch Third pouch First pouch

first pouch

A young boy with a tooth abscess from a longstanding infection suffers damage of the lingual nerve as it enters the oral cavity. Which of the following structures contain cell bodies of injured nerve fibers? Trigeminal and submandibular ganglia Geniculate and otic ganglia Geniculate and pterygopalatine ganglia Trigeminal and dorsal root ganglia Geniculate and trigeminal ganglia

geniculate and trigeminal ganglia The lingual nerve is joined by the chorda tympani in the infratemporal fossa. Therefore, the lingual nerve contains general somatic afferent (GSA) fibers whose cell bodies are located in the trigeminal ganglion and special somatic afferent (SSA) or taste fibers that have cell bodies located in the geniculate ganglion.

During a routine cranial nerve exam, the doctor asks his patient to stick out (protrude) his tongue. Which of the following muscles would be responsible for this action? Genioglossus Hyoglossus Styloglossus Intrinsic tongue muscles Palatoglossus

genioglossus

A 46-year-old man presents to you complaining of loss of taste and general sensation in the posterior part of his tongue. A CT scan suggests that the patient has Eagle's syndrome, in which there is an elongated styloid process and/or a heavily calcified stylohyoid ligament that may be impinging on which nerve? Glossopharyngeal Hypoglossal Vestibulocochlear Facial Accessory

glossopharyngeal

What nerve innervates the posterior 1/3 of the tongue? External branch of superior laryngeal Facial Glossopharyngeal Internal branch of superior laryngeal

glossopharyngeal

What nerve innervates the stylopharyngeus muscle? Glossopharyngeal External branch of superior laryngeal Internal branch of superior laryngeal Facial

glossopharyngeal

A 10-year-old boy was admitted to the hospital with a sore throat, earache, and high fever. On examination, he had severely swollen palatine tonsils (tonsillitis). What nerve carries the sensory input for most of the patient's symptoms? Greater palatine Vagus Lesser palatine Glossopharyngeal Posterior superior alveolar

glossopharyngeal The glossopharyngeal nerve (CN IX) is responsible for visceral sensation to the posterior one third of the tongue, palatine tonsils, soft palate, pharyngotympanic tube, tympanic (or middle ear) cavity, and pharynx. Therefore, CN IX would be responsible for the pain associated with the boy's earache and sore throat. The palatine tonsillitis may be blocking the opening of the pharyngotympanic tube (auditory or eustachian), exacerbating the symptoms of the patient. The glossopharyngeal nerve is also responsible for the afferent limb of the gag reflex

A 4-year-old girl was taken to her doctor because of a severe sore throat, difficult nasal respiration, mouth breathing, and ear pain. The physical examination and history taken by the physician revealed a high temperature but no cough or nasal discharge. The nasal mucosa and middle ear were mildly inflamed. The child's voice reflected a blocked nasal passageway. Lung sounds were normal. Which of the following statements best describes the most likely cause of the child's mouth breathing and rhinitis? Inflammation of the lingual tonsils Mastoiditis Inflammation of the palatine tonsils Laryngitis Hypertrophy of the pharyngeal tonsils (adenoiditis)

hypertrophy of the pharyngeal tonsils (adenoiditis)

The superior limb of ansa cervicalis travels with what nerve? Vagus Lingual Hypoglossal Chorda tympani

hypoglossal nerve

How can the vagus nerve be distinguished from the sympathetic chain from a posterior view? Only the chain is in the carotid sheath The vagus nerve lies more posterior The sympathetic chain is thicker Look for the superior cervical ganglion

look for the superior cervical ganglion

A patient is brought to the ED after much of his scalp has been removed as a result of a motorcycle accident in which the patient's head abutted the back bumper of a semitrailer. The layer of the anatomical scalp in which the separation occurred is most likely?

loose areolar tissue

Your 65-year-oldpatient has hearing loss due to otosclerosis of the auditory ossicles. This is interfering with sound reception, which normally proceeds from the tympanic membrane to the inner ear via which of the following order of structures? Malleus, incus, stapes, round window Malleus, incus, stapes, oval window Incus, malleus, stapes, round window Incus, malleus, stapes, oval window Malleus, stapes, incus, round window

malleus, incus, stapes, oval window

What is the innervation of the lateral pterygoid muscle? Mandibular division of CN V CN IX Chorda tympani from CN VII CN X

mandibular division of CN V

A 57-year-old man comes to a local hospital with fever, headache, nausea, and vomiting. Laboratory tests reveal an infection, and radiologic examination localizes the infection to the cavernous sinus. Which of the following nerves would be unaffected by this condition? Oculomotor nerves Trochlear nerves Ophthalmic nerves Mandibular nerves Abducens nerves

mandibular nerves

A 21-year-old professional boxer receives a series of powerful punches to the side of his face, which fractures the left mandible slightly superior to the mandibular angle as indicated by the arrow on the given CT scan. Resultant muscle spasticity causes his jaw to close, making it difficult to remove his mouthpiece. Which of the following muscles is acting to close the jaw? Temporalis Posterior digastric Zygomaticus major Masseter Lateral pterygoid

masseter

A 23-year-old female professional student wakes up with a facial nerve (CN VII or Bell) palsy. What muscle will continue to function despite this affliction?

masseter

A 23-year-old female professional student wakes up with a facial nerve (CN VII or Bell) palsy. What muscle will continue to function despite this affliction? Platysma Levator labii superioris Masseter Zygomaticus major Buccinator

masseter

A 31-year-old hockey player is hit in the head by a puck. His radiogram shows a fracture of the foramen rotundum. Which of the following nerves would be damaged by this event?

maxillary nerve The maxillary nerve runs through the foramen rotundum; the ophthal-mic nerve runs through the supraorbital fissure; the mandibular nerve passes through the foramen ovale; the optic nerve runs through the optic canal; and the trochlear nerve passes through the superior orbital fissure.

You are examining a 53-year-old patient who is complaining of dry eyes. After confirming that all of the structures related to tearing within the orbit are functioning normally, you suspect a branch of which of the following nerves might be lesioned within the inferior orbital fissure?

maxillaryV2 (zygomatic branch) A branch of the maxillary nerve, the zygomatic, conducts postganglionic fibers from the pterygopalatine ganglion toward the lacrimal gland to control tear production.

A 55-year-old man presented with painful vesicles on his chin and lower lip. He was diagnosed with a dermatomal herpes zoster inflammation (shingles). Which of the following nerves likely transmitted the sensations of pain?

mental

A 9-year-old girl with a history of strep throat has her palatine tonsils surgically removed. She returns to the hospital 3 days later with a high fever and chest pain. A physician orders a CT scan, which revealed spread of infection into the superior mediastinum. What is the most likely route for this infection to descend through the neck to reach the superior mediastinum? Carotid sheath Parapharyngeal space Retropharyngeal space Buccal space Suprasternal space

retropharyngeal space

A 45-year-old man goes to his physician complaining of having trouble with his speech (dysarthria) and involuntary contractions (fasciculations) within his tongue muscles. The doctor notes that his tongue deviates to the right when the patient attempts to protrude his tongue, as seen in the figure. What nerve is most likely damaged in this patient? Right hypoglossal nerve Right vagus nerve Left glossopharyngeal nerve Left hypoglossal nerve Left vagus nerve

right hypoglossal nerve (deviated toward the right)

After asking a 47-year-old woman to open her mouth wide and say "Ah," the physician notes deviation of the uvula to the left side and asymmetry in the elevation of the soft palate, with the right side of the palate sagging, as noted in the figure. What specific nerve is most likely damaged? Right hypoglossal nerve Left glossopharyngeal nerve Left vagus nerve Right vagus nerve Left hypoglossal nerve

right vagus nerve (deviates away from the affected side)

The given photo shows a superior view of the head of a baby boy with scaphocephaly. Which of the following sutures closed prematurely in this infant? Metopic Sagittal Coronal Squamous Lambdoid

sagittal suture

A 24-year-old man came to his physician with a history of chronic maxillary sinusitis. A computed tomography (CT) scan reveals a soft-tissue mass in the superior aspect (or roof) of the right maxillary sinus. Functional endoscopic sinus surgery (FESS) was performed to biopsy the mass. Postoperatively, the patient experiences paresthesia and numbness of the skin of the right inferior eyelid and upper lip. Which nerve was most likely damaged during the surgery?

second division of the trigeminal nerve

When the middle concha is removed, it will expose what anatomical structure? Sphenoethmoid Recess Semilunar hiatus Nasolacrimal duct Hypopheseal fossa

semilunar hiatus

Lesion of the lingual nerve proximal to the chorda tympani joining it will lead to loss of _________________. saliva from the submandibular and sublingual salivary glands. taste from the posterior 1/3 of the tongue. sensation from the anterior 2/3 of the tongue. taste from the anterior 2/3 of the tongue. sensation from the posterior 1/3 of the tongue.

sensation from the anterior 2/3 of the tongue

What structure does the inferior alveolar nerve supply? Teeth of upper jaw Tip of the tongue Skin of the chin Inside of the cheeck

skin of the chin

A 14-year-old boy hits his head on the asphalt road after falling off his skateboard. His radiograph reveals damage to the sella turcica. This is probably due to fracture of which of the following bones?

sphenoid bone

A 67-year-old woman comes to her physician complaining of visual loss. Her magnetic resonance imaging (MRI) scan shows an enlarged pituitary gland that lies in the sella turcica, immediately posterior and superior to which of the following structures?

sphenoid sinus The pituitary gland lies in the hypophyseal fossa of the sella turcica of the sphenoid bone, which lies immediately posterior and superior to the sphenoid sinus and medial to the cavernous sinus. The frontal sinus lies in the frontal bone; the maxillary sinus lies in the maxilla lateral to the lateral wall of the nasal cavity; the ethmoid sinus (composed of air cells) lies between the orbit and the nasal cavity; and the mastoid air cells lie in the mastoid process of the temporal bone.

A bony overgrowth narrows the pterygomaxillary fissure, compressing the third part of the maxillary artery. As a result, blood flow will be reduced in which of the following arteries? Middle meningeal Sphenopalatine Ophthalmic Superficial temporal Inferior alveolar

sphenopalatine

A 65-year-old man complains of a persistent nosebleed. His physician uses a cotton swab to apply pressure at the source, the inferior and posterior aspects of the lateral nasal wall. Which artery is the most likely source of the bleeding? Facial Greater palatine Infraorbital Anterior ethmoidal Sphenopalatine

sphenopalatine (source of posterior nose bleeds)

A 23-year-old man reports to physician due to shoulder weakness and instability. After removing his shirt, his left shoulder appears to reside lower than his right shoulder, asymmetry noted in the figure. During an examination, the patient is unable to abduct his left arm over his head and shows an inability to shrug (or elevate) his left shoulder against resistance. What nerve was most likely damaged in this patient? Accessory nerve Vagus nerve Hypoglossal nerve Facial nerve Glossopharyngeal nerve

spinal accessory nerve

A dermatologist performed a biopsy on a suspicious mole on the right side of the posterior neck of a 57-year-old male construction worker. Pathology confirmed a malignant melanoma, so the physician excised a substantial amount of tissue surrounding the mole. After the procedure, the patient experienced difficulty elevating his right shoulder and lifting his right arm over his head. No sensory deficits were seen. What nerve was most likely damaged in this patient? Thoracodorsal nerve Dorsal scapular nerve Accessory nerve Long thoracic nerve Axillary nerve

spinal accessory nerve

What artery pierces the thyrohyoid membrane? ascending pharyngeal artery superior laryngeal artery lingual artery superior thyroid artery

superior laryngeal artery

What structure is in danger if an object becomes lodged in the piriform recess? Recurrent laryngeal nerve Superior laryngeal artery Superior thyroid artery External laryngeal nerve Inferior laryngeal nerve

superior laryngeal artery

A 48-year-old patient complains of double vision, cannot abduct her eye and lacks a corneal reflex. Where is the likely location of the lesion? Orbital floor Optic canal Superior orbital fissure Foramen rotundum Inferior orbital fissure

superior orbital fissure

An 82-year-old woman develops a dural meningioma (tumor) that compresses the confluence of the dural venous sinuses. On the given contrast venogram from an angiographic series, drainage from which of the following labeled vessels would be impeded by the tumor?

superior sagittal sinus

An 82-year-old woman develops a dural meningioma (tumor) that compresses the confluence of the dural venous sinuses. On the given contrast venogram from an angiographic series, drainage from which of the following labeled vessels would be impeded by the tumor? Superior sagittal sinus Transverse sinus Cavernous sinus Superior petrosal sinus Inferior petrosal sinus

superior sagittal sinus

The above is a volume rendered CT angiogram to examine the carotid artery system in a patient who has had a stroke. The red arrow is pointing to which of the following arteries? Vertebral Lingual Internal laryngeal Superior thyroid External carotid

superior thyroid

Where is the lacrimal gland located in relation to the orbit? Inferolateral Inferomedial Superomedial Superolateral

superolateral

The frontal nerve branches into the supratrochlear nerve and what other nerve? Supraorbital Nasociliary Lacrimal Posterior ethmoidal

supraorbital

A paralyzed right true vocal fold is most likely associated with which of the following situations? Obstruction of the thoracic duct Surgical removal of the thyroid gland Repair of an aortic aneurysm A gunshot wound below the second rib Repair of a patent ductus arteriosus

surgical removal of the thyroid gland

Parasympathetic nerve fibers to the parotid gland synapse in the otic ganglion run in the facial nerve originate in the superior salivatory nucleus run in the masseteric nerve

synapse in the otic ganglion

A 17-year-old woman presents with an anterior dislocation of her temporomandibular joint (TMJ), as shown in the diagram. With her mandible stuck in the protruded (protracted) position, her dentist pulls the mandible inferiorly to enable the tone of a muscle to retrude (retract) the mandible to its normal position. Which muscle returns the mandibular condyle back into its normal position after it clears the articular eminence? Temporalis Medial pterygoid Stylohyoid Masseter Lateral pterygoid

temporalis

A 38-year-old man has had thyroid surgery to remove his papillary carcinoma. The external laryngeal nerve that accompanies the superior thyroid artery is damaged during the surgery. This injury could result in a severe impairment of function of which of the following? Widening the rima glottidis Relaxing the vocal cords Tensing the vocal cords Rotating the arytenoid cartilages Abducting the vocal cords

tensing the vocal cords

The external laryngeal nerve of a 23-year-old man becomes ensnared and tightly compressed by a tortuous superior thyroid artery, which parallels the course of this nerve. Which of the following functions is most likely to be affected? Sensation below the true vocal fold Sensation above the true vocal fold Abduction of the vocal cord Tension of the vocal cord Depression of the hyoid bone

tension of the vocal cord

A young child suffers a debilitating condition that includes progressive degeneration of the motor axons that innervate the masseter muscle. Which of the following muscles is most likely to exhibit the same fate? Stylopharyngeus Levator veli palatini Orbicularis oris Tensor tympani Genioglossus

tensor tympani (it is supplied by trigeminal as well)

A 31-year-old football player with a head injury is brought to a local emergency department. Physical examination, radiogram, and a magnetic resonance imaging scan indicate a lesion of the trigeminal nerve. Which of the following muscles is most likely paralyzed? Palatoglossus Cricothyroid Geniohyoid Levator veli palatini Tensor veli palatini

tensor veli palatini

While resecting a tumor in the palate, a surgical intern removes the mass but finds that it is deeply invasive into the tendon that loops around the pterygoid hamulus. Which of the following muscles would most likely be paralyzed? Tensor tympani Tensor veli palatini Stylohyoid Superior pharyngeal constrictor Levator veli palatini

tensor veli palatini

A 67-year-old man is known to have infection in the superior petrosal sinus. The infected sinus lies in the margin of which of the following structures? Falx cerebelli Diaphragma sellae Straight sinus Falx cerebri Tentorium cerebelli

tentorium cerebelli

The radiologic report on your 65-year-old patient indicates a brain tumor associated with cerebral edema (swelling) that has resulted in herniation of the uncus of the brain through the tentorial notch with potentially life threatening consequences. The tentorial notch is an opening in which of the following?

tentorium cerebelli

A 67-year-old man is known to have infection in the superior petrosal sinus. The infected sinus lies in the margin of which of the following structures?

tentorium cerebelli The superior petrosal sinus lies in the margin of the tentorium cerebelli. The falx cerebri contains the inferior and superior sagittal sinuses, and the falx cerebelli encloses the occipital sinus. The diaphragma sellae forms the dural roof of the sella turcica. The straight sinus runs along the line of attachment of the falx cerebri and tentorium cerebelli

A 9-year-old girl suffers from the mumps, causing unilateral inflammation of her right parotid gland, as seen in the photo. The girl is experiencing great pain due to the stretched capsule of the parotid gland. Her physician is also concerned about the condition of the structures contained within the gland. Which of the following structures may be directly compressed in this situation?

the auriculotemporal nerve The auriculotemporal nerve, a branch of the mandibular division of the trigeminal nerve (CN V3), traverses the substance of the parotid in its course from the infratemporal fossa to the lateral scalp. This nerve is the major sensory supply across the mandibular region, provides the parasympathetic secretomotor route to the parotid, and innervates the connective tissue within the gland itself.

A 43-year-old man presents with loss of control of facial expression across the entire right side. The corner of his mouth droops on the right side, but he can clench his jaw and chew on demand. During examination, his physician also notes loss of hearing on the right side, and the patient has difficulty maintaining balance while standing on one foot. The patient's corneal (blink) reflex is absent in the right eye, but cutaneous sensation is normal on the entire face. The physician orders radiographic imaging in anticipation of finding a tumor. What is the most likely location of the tumor?

the internal acoustic meatus The only location where CN VII and CN VIII can be affected simultaneously is at the internal acoustic meatus (in the wall of the posterior cranial fossa), where the paired nerves leave the cranial cavity to enter the petrous part of the temporal bone.

Your 56-year-old male patient is being evaluated for snoring and sleep apnea. An uvulopalatopharyngoplasty has been proposed, which removes the uvula. This structure is connected to which of the following? The palatoglossal arch The palatine tonsil The hard palate The soft palate The palatine frenulum

the soft palate

A 47-year-old woman with a history of multiple sclerosis comes to her doctor complaining of sudden bursts (paroxysms) of pain in her mandible, especially in the lower lip, mandibular teeth and gingivae, and cheek on her right side. This debilitating pain is often triggered by eating, talking, or brushing her teeth and often gets worse as the day progresses. Which nerve is the source of her pain?

third division of trigeminal nerve

A professional student finds out she has a perfect score on the anatomy portion of her board examination and her muscles of facial expression produce a long anticipated smile. What muscle is assisting her in elevating her labial commissure bilaterally to smile?

zygomaticus major

A 24-year-old swimmer presents with external ear canal inflammation (otitis externa). The patient coughs during your otoscopic examination. The cough results because some of the tympanic membrane and the external ear (concha) are supplied by a nerve that also innervates the larynx. What is this nerve? Accessory Vagus Great auricular nerve Facial Glossopharnygeal

vagus

What structure is found in the carotid sheath? Ansa Cervicalis Phrenic nerve External jugular vein Subclavian vein Vagus nerve

vagus nerve

The superior sagittal sinus contains mostly ______________.

venous blood The superior sagittal sinus is a dural sinus. Dural sinuses are essentially large valveless veins within the cranial vault.

A severe unilateral (rotary) dislocation in the cervical region of the vertebral column is most likely to damage which of the following? External carotid artery Ansa cervicalis Vertebral artery Sympathetic trunk Superior cervical ganglia

vertebral artery

A 60-year-old female yodeler with a 43-year history of smoking complains of pain during swallowing and hoarseness in her voice. A fiberoptic endoscopy reveals a laryngeal squamous cell carcinoma at the location identified by the arrow within the given figure. What structure is most likely affected by this laryngeal cancer? Epiglottis Infraglottic cavity Vocal folds Vestibular folds Laryngeal vestibule

vocal folds (arrow is pointing to the vocal fold)

Choose the appropriate lettered structure in the radiograph of the head (see figure). Which sinus opens into the hiatus semilunaris of the middle nasal meatus by way of the frontonasal duct or infundibulum? A B C D

A (frontal sinus)

Choose the appropriate lettered structure in this MRI scan showing a transaxial section through the head (see figure). Which structure is formed by the perpendicular plate of the ethmoid bone, vomer, and septal cartilage?

A (nasal septum) The nasal septum is formed primarily by the perpendicular plate of the ethmoid bone, vomer, and septal cartilage.

Lesion of the trunks of the brachial plexus is most likely to occur from a penetrating wound into which of the following labeled areas in the given drawing of the neck regions? A B C D E

A (posterior triangle)

Choose the appropriate lettered structure in this MRI scan showing a transaxial section through the head (see figure). Which structure is formed by the perpendicular plate of the ethmoid bone, vomer, and septal cartilage? A B C D E

A (the nasal septum)

A tumor growing at the base of the skull impinges upon the opening indicated by the arrow, severely compressing its contents. Which of the following conditions is the most likely result?

Arterial supply to the dura mater is reduced the middle meningeal artery goes through the foramen spinosum which would cause less arterial supply to the dura mater if this opening was impinged

A 35-year-old man complains to his physician that he feels congested, has trouble with nasal breathing, and is experiencing a yellowish nasal mucus discharge. He also mentions that his right side upper molar teeth ache terribly. A thorough physical examination reveals maxillary sinusitis. The discharge from this sinus initially drains into the nasal cavity at which of the labeled points within this drawing of the lateral nasal wall? A B C D E

C (the semilunar hiatus in the middles meatus)

In the ED you are treating a patient with a severe upper neck wound. You want to temporarily stop the bleeding from the common carotid artery. To do so you would press strongly against the anterior tubercle of which of the following? T2 C6 C2 C4 T1

C6

A pitcher was hit on the right side of his head by a baseball. He fell to the ground and was unconscious for about 4 minutes. When he awoke, he complained of a severe headache and considerable pain and was rushed to hospital. He was initially conscious but suddenly became very drowsy. On examination, a large bruise was observed on his right temple and his right pupil was dilated. A radiograph of his cranium revealed a fracture of the squamous part of the temporal bone. Which of the following statements best describes the most likely cause of the pitcher's symptoms and signs?

Fracture of the calvaria and rupture of the middle meningeal artery producing an extradural hematoma

While jogging on a trail you come upon a child who fell off her bike and has severe facial lacerations that are bleeding profusely. In order to most effectively curtail the bleeding, where would you put pressure (bilaterally)?

Horizontal ramus of the mandible just anterior to the attachment of the masseter

Some patients with colds have used a commercially available homeopathic remedy for colds (gel placed in nostrils) that contains zinc. Some users subsequently developed anosmia (loss of sense of smell) thought to be due to destruction of the olfactory neurons located within the olfactory epithelium by overexposure to zinc. Where is this epithelium located? In the superior parts of the lateral and septal walls of the nasal cavity On the superior aspect of the hard palate In the middle meatus In the superior aspect of the cribriform plate In the sphenoid ethmoidal recess

In the superior parts of the lateral and septal walls of the nasal cavity

Your 2-year-old patient is constantly tugging at his ear. He also is spitting out food suggesting that food is not tasting well to him. What condition do you believe the patient has? A lesion of jugular foramen, affecting his vagus nerve Otitis externa (inflammation of outer ear),which is affecting his mandibular nerve A lesion of the infratemporal fossa affecting his auriculotemporal nerve Otitis interna (inflammation of inner ear), which is affecting his chorda tympani nerve Otitis media (inflammation of middle ear), which is affecting his chorda tympani nerve

Otitis media (inflammation of middle ear), which is affecting his chorda tympani nerve

A 20-year-old man was slashed in the right anterior cervical region (anterior triangle). An ambulance was called and the paramedics stopped the bleeding from the external jugular vein. He was taken to an emergency room where a physician examined him. When the man was asked to protrude his tongue, its apex deviated to the right side. The physician concluded that there was a nerve lesion. Which of the following statements best describes the most likely cause of the deviation of the man's tongue? Injury of the transverse cervical nerve (C2 and C3) Injury of the pharyngeal plexus of nerves Paralysis of the right hypoglossal nerve (CN XII) Injury of the vagus nerve Injury of the glossopharyngeal nerve (CN IX)

Paralysis of the right hypoglossal nerve (CN XII)

While planning a delicious dinner for his former anatomy professors, a doctor finds himself salivating at the thought of the feast. What description accurately describes the secretomotor pathway for innervation of the submandibular gland? Parasympathetic fibers via the inferior alveolar nerve Sympathetic fibers via the lingual nerve Sympathetic fibers via the hypoglossal nerve Parasympathetic fibers via the chorda tympani nerve Parasympathetic fibers via the mandibular branch of the facial nerve

Parasympathetic fibers via the chorda tympani nerve

Describe the borders of the posterior triangle of the neck. Anterior border of sternocleidomastoid muscle, inferior border of the mandibular body, and midsagittal plane from the mental protuberance of the mandible to the jugular notch of the sternum. Superior borders of the anterior and posterior digastric muscle bellies and inferior border of the mandibular body. Posterior border of sternocleidomastoid muscle, posterior border of the anterior scalene muscle, and anterior border of the middle scalene muscle. Posterior border of sternocleidomastoid muscle, anterior border of trapezius muscle, and middle third of the clavicle.

Posterior border of sternocleidomastoid muscle, anterior border of trapezius muscle, and middle third of the clavicle

A special image reconstruction from a contrast-enhanced CT scan shows the "venous angle." What does this refer to? The angle that the axillary vein makes as it crosses the clavicle The angle that the anterior jugular vein makes with the midline of the neck The angle that the internal jugular vein makes as it crosses the sternocleidomastoid muscle The junction of the internal jugular and subclavian veins The junction of the two brachiocephalic veins to form the superior vena cava

The junction of the internal jugular and subclavian veins

A 55-year-old man consulted his family physician about a swelling antero-inferior to his left ear. At the exam, he also complained that the left side of his face felt weak and the corner of his mouth was drooping. On examination, the physician detected a hard mass deep within the substance of the parotid gland. He also observed that the man's facial muscles on the left side were weaker than on the right side. Which of the following statements best describes the most likely cause of the patient's complaints?

The parotid plexus of the facial nerve (CN VII) was being compressed by a carcinoma of left parotid gland

In the provided X-ray, an opening in the skull (foramen ovale) is identified at the tip of the red arrow. If the nerve that traverses this cranial opening (CN V mandibular branch) were damaged, what signs or symptoms would most likely be seen in the patient?

Unilateral muscles of mastication paralysis

All intrinsic musculature of the larynx is innervated by branches of CN ____. XII. IX. VII. XI. X.

X (vegas)

Palatoglossus is innervated by cranial nerve ________. VII. X. XII. XI. IX.

X vegas

Sensory fibers in the pharyngeal plexus are conveyed primarily by cranial nerve ____. V. IX. VII. XI. X.

XI (glossopharyngeal ) SENSORY IS GLOSSO CN IX serves as the sensory limb of the pharyngeal plexus and CN X as the motor limb

A 38-year-old man comes to his doctor complaining of double-vision (diplopia). The doctor notes the patient looks "cross-eyed" due to the right eye directed medial to the midposition of his gaze. When the patient is asked to direct his vision to his right, the right eye is unable to go past the midposition. No other visual deficits are noted. What specific nerve is most likely damaged? Oculomotor nerve Trochlear nerve Abducent nerve Facial nerve Optic nerve

abducens nerve

A 38-year-old woman consulted her physician about a persistent cough, nasal congestion, and pain in her left cheek and superior molar teeth. After examination, the physician told her she had acute paranasal sinusitis. Which of the following statements best describes the most likely cause of the patient's symptoms? Acute sphenoidal sinusitis Acute frontal sinusitis Acute maxillary sinusitis Acute petrosal sinusitis Acute ethmoidal sinusitis

acute maxillary sinusitis

The left recurrent laryngeal nerve loops around what vessel? Aorta Subclavian artery Brachiocephalic artery Common Carotid artery

aorta

As a treatment for intractable hiccups, an anesthesiologist plans to paralyze the left hemidiaphragm. Where will he likely inject an anesthetic solution? The left phrenic nerve as it crosses anterior to the scalenus anterior muscle Around the left vagus nerve at C3 Around the left phrenic nerve as it enters the diaphragm Around the left vagus nerve as it crosses the root of the neck Around the left phrenic nerve as it arises from the brachial plexus

around the left phrenic nerve as it crosses anterior to the scalenus anterior muscle

Your 89-year-old patient is losing vision due to macular degeneration. Relative to the image shown above of a right eye, where is this degeneration occurring? At an oval area inferior to the optic disk Within the center of the optic disk At an oval area to the left (lateral) to the optic disk At an oval area to the right (medial) to the optic disk At an oval area superior to the optic disk

at an oval areal to the left (lateral) to the optic disk

In order to perform a submandibular sialogram (radiographic study of the submandibular duct) a cannula for injection of contrast material would be placed into the orifice where in that duct? Immediately inferior to the lower second premolar At most posterior aspect of the vallecula Into the incisive foramen Into the foramen cecum At the base of the lingual frenulum

at the base of the lingual frenulum

A 9-year-old girl suffers from the mumps, causing unilateral inflammation of her right parotid gland, as seen in the photo. The girl is experiencing great pain due to the stretched capsule of the parotid gland. Her physician is also concerned about the condition of the structures contained within the gland. Which of the following structures may be directly compressed in this situation?

auriculotemporal nerve

Following total removal of your patient's parotid gland, he suffers from a condition known as gustatory sweating, whereby he sweats profusely on his ipsilateral cheek every time he eats. This occurred because the damaged fibers in the nerve that innervated his parotid gland communicated with the sweat glands on the face after regeneration. What is the name of this nerve that carries parasympathetic fibers to the parotid gland?

auriculotemporal nerve The auriculotemporal nerve carries parasympathetic fibers that originate in the otic ganglion and that received preganglionic fibers from CN IX (glossopharyngeal nerve)

A 37-year-old patient has an infectious inflammation of the dural venous sinus closest to the pituitary gland and a secondary thrombus formation. Which of the following is the most likely site of infection?

cavernous sinus The dural venous sinus nearest the pituitary gland is the cavernous sinus

Which of the following is located in the posterior cranial fossa?

cerebellum

A 68-year-old man arrived at the ER with sudden onset of the worst headache of his life, lethargy, and nuchal rigidity. He quickly loses consciousness and dies. Autopsy reveals no traumatic injury; however, the man's subarachnoid space is filled with blood, as seen in the photo. Damage to what blood vessel most likely led to the death of this patient? Cerebral arterial circle Superior cerebral veins Common carotid artery Middle meningeal artery Facial artery

cerebral arterial circle (circle of willis) Remember that all major vessels of the brain travel within the subarachnoid space, and subarachnoid hemorrhages are one of the few cerebral hemorrhages that can occur in the absence of trauma, often seen following rupture of a saccular aneurysm within the cerebral arterial circle aka circle of willis.

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? Chorda tympani in the middle ear cavity Lesser petrosal nerve Lingual nerve at its origin Superior cervical ganglion Auriculotemporal nerve

chorda tympani in the middle ear cavity

Which of the following structures are located in the same layer of the eye? Retina, ora serrata, & ciliary body Sclera, pupil, & cornea Choroid, ciliary body, & iris Cornea, retina, & iris

choroid, ciliary body, and iris

A 51-year-old woman traveling through British Columbia can see the beautiful blue sky with white clouds but is unable to focus on her face in the mirror. Her lack of accommodation results from paralysis of which of the following muscles? Tarsal muscle Dilator pupillae Sphincter pupillae Ciliary muscles Orbitalis muscles

ciliary muscles

You arrive at the scene of a motor vehicle accident and the driver is severely bleeding from a laceration in his right brachial artery near the head of the humerus. You know you can control bleeding to this vessel by doing which of the following? Compressing the subclavian artery against the transverse process of the first thoracic vertebrae medial to the scalenus anterior Compressing the subclavian artery against the first rib as it passes posterior to the scalenus anterior Compressing the brachiocephalic artery by deeply pressing in the scalene triangle Compressing the subclavian artery as it crosses anterior to the clavicle Compressing the brachiocephalic artery by pressing posterior to the right sternoclavicular joint

compressing the subclavian artery against the first rib as it passes posterior to the scalenus anterior

Upon neurological examination, you notice a slow pupillary light reflex in a patient's right eye. Which of the following is consistent with this sign? Compression of the right oculomotor nerve Compression of the right facial nerve proximal to the geniculate ganglion Lesion of the left long ciliary nerves Lesion of the right nasociliary nerve Compression of the right facial nerve distal to the geniculate ganglion

compression of the right oculomotor nerve

A 41-year-old woman overdoses on some prescription medications that have a common side effect of autonomic nerve stimulation. Which of the following conditions or actions results from stimulation of the parasympathetic fibers to the eyeball? Enhanced vision for distant objects Contraction of capillaries in the iris Flattening of the lens Contraction of the ciliary muscle Dilation of the pupil

contraction of the ciliary muscle contraction causes release on the zonular ligaments causing the pupils to be less dilated = parasympathetic innervation

A baby girl presents with a disproportionately wide skull with a short occipitofrontal diameter, as depicted in the given surface shaded CT reconstruction. What cranial suture most likely closed prematurely to result in this cranial deformity? Sphenosquamous Sagittal Coronal Sphenoparietal Lambdoid

coronal cuture Premature closure of the coronal suture leads to brachycephaly (G: short head), which leads to a disproportionately wide skull with a short occipitofrontal diameter.

During surgery on a 56-year-old man for a squamous cell carcinoma of the neck, a surgeon notices profuse bleeding from the deep cervical artery. Which of the following arteries must be ligated immediately to stop bleeding? Transverse cervical artery Ascending cervical artery Thyrocervical trunk Costocervical trunk Inferior thyroid artery

costocervical trunk

The buccinator is innervated by _______________

cranial nerve VII (facial)

You are examining a 25-year-old patient in the ED after he was involved in a motorcycle accident in which he was not wearing a helmet. Fluid is leaking from his right nostril and he cannot smell on that side. Which of the following osseous structures is most likely fractured?

cribriform plate

Following a procedure to remove the thyroid gland (thyroidectomy), a surgeon reports the right recurrent laryngeal nerve was incised accidentally. Which of the following muscles would continue to function despite this iatrogenic damage? Thyroepiglottic Posterior cricoarytenoid Cricothyroid Thyroarytenoid Lateral cricoarytenoid

cricothyroid (innervated by external branch of superior laryngeal nerve)

A 68-year-old man was choking on a piece of steak at a family restaurant. Despite attempts to dislodge the food via abdominal thrusts (or the Heimlich maneuver), his upper airway remained blocked. An emergency medical technician (EMT), eating at the scene, performed an emergency tracheotomy to enable the man to breathe. Which subcutaneous structure was most likely cut during this procedure? Isthmus of thyroid gland Tracheal rings Cricothyroid membrane Cricoid cartilage Thyrohyoid membrane

cricothyroid membrane

The nerve accompanying the superior thyroid artery may be damaged during an operation on the thyroid gland. Which of the following functional defects may result from this injury? Decreased tension of the vocal cord Lack of abduction of the vocal cord Paralysis of the vocalis muscle Loss of lateral rotation of the arytenoid cartilages Loss of sensation above the vocal cord

decreased tension of the vocal cord

Startled by a loud noise while shaving his head with a straight razor, a young man accidentally cuts his scalp, severing branches of the supraorbital and superficial temporal vessels. The scalp wound appears modest but bleeds profusely. In what layer of the scalp do the severed vessels reside?

dense connective tissue

A patient damages the cranial nerve indicated by the arrow in the figure. What signs or symptoms would be evident in a patient with this nerve lesion? (hypoglossal nerve) Deviation of the tongue to the ipsilateral side Loss of gag reflex on the ipsilateral side Ipsilateral loss of parotid gland secretion Inability to elevate the ipsilateral shoulder Deviation of the uvula to the contralateral side

deviation of the tongue to the ipsilateral side One of the rootlets of the hypoglossal nerve (CN XII) is identified in this photo. CN XII emerges from the brainstem in the medulla between the pyramid medially and the olive (inferior olivary nucleus) laterally. The hypoglossal nerve innervates all of the intrinsic muscles of the tongue and most of its extrinsic muscles with the lone exception being the palatoglossus muscle are innervated by the vagus nerve (CN X).

Vallate papillae are taste receptors located where? On the tip of the tongue On the soft palate On the epiglottis On the hard palate Directly anterior to the terminal sulcus on the tongue

directly anterior to the terminal sulcus on the tongue

The buccinator is supplied by facial nerve the mandibular division of the trigeminal nerve Buccal nerve zygomatic nerve

facial nerve

A 27-year-old intoxicated male presents by ambulance after an altercation at a local tavern. Paramedics note an apparent stab wound to the right posterolateral neck (posterior to the sternocleidomastoid muscle). There was minimal blood noted at the scene and there is no active bleeding at this time. The patient is on no regular medications and has no known medication allergies. His stated weight is 195 lbs and he quit smoking 1 year ago. Although his speech is slurred and he has the odor of alcohol on his breath, he is somewhat cooperative and polite. The airway appears to be clear and breath sounds are equal. Initial vital signs include a blood pressure of 155/95, pulse of 105, and respiratory rate of 22. After removing his jacket and shirt, the nurse notices the right scapula is laterally displaced. Which of the following nerve injuries would most likely explain this finding?. Thoracodorsal Long thoracic Spinal accessory Axillary Dorsal scapular

dorsal scapular

What is the action of the temporalis muscle? is a muscle of facial expression elevates the mandible opens the mouth protrudes the mandible

elevates the mandible

A 23-year-old man was punched in the left eye in a bar fight, which resulted in periorbital edema and ecchymosis. In the ER, the man refuses to open his eye, and when his eyelids are pried opened he exhibits vertical diplopia, specifically when asked to look up. A coronal CT reformat image reveals asymmetry in the left orbit and the superior antrum of the maxillary sinus, apparent in the given image. What is the most likely cause of the patient's diplopia? Entrapment of inferior rectus muscle Detached retina Damage to infraorbital nerve Paralysis of lateral rectus muscle Paralysis of superior oblique muscle

entrapment of inferior rectus muscle

A 25-year-old man is involved in an automobile accident and slams his head into a concrete wall of a bridge. His computed tomography (CT) scan reveals that the middle meningeal artery has ruptured but the meninges remain intact. Blood leaking from this artery enters which of the following spaces?

epidural space

An infection in which of the following paranasal sinuses is most likely to be associated with optic neuritis? Frontal Ethmoid Palatine Sphenoid Maxillary

ethmoid Because of the proximity of the posterior ethmoidal cells to the optic canal, and because the medial wall of the orbit is very thin, the spread of infection to the optic nerve and/or eye from the ethmoidal sinus is more common than from any of the other paranasal sinuses.

Which of the following pairs of nasal sinuses are visible in the above coronal CT? Sphenoidal and palatine Maxillary and frontal Maxillary and sphenoid Ethmoid and sphenoid Ethmoid and maxillary

ethmoid and maxillary

The maxillary artery is a terminal branch of what artery? Superficial temporal artery External carotid Vertebral artery Internal carotid

external carotid artery

A 59-year-old man went to his doctor unable to close his right eye. The physical examination also revealed asymmetry in his smile and an inability to wrinkle the right side of his forehead, as seen in the figure. What cranial nerve is affected in this patient?

facial nerve

Most senior citizens dislike the bass audio frequencies augmented by a large subwoofer in a teenager's car. But, one 68-year-old man came to his doctor complaining of hyperacusis, or heightened sensitivity to these loud, low-frequency sounds. The results from an audiometer hearing test reveal normal hearing for a man of his age. Given the presentation, what cranial nerve is most likely involved with his hyperacusis? Hypoglossal nerve Glossopharyngeal nerve Vagus nerve Facial nerve Vestibulocochlear nerve

facial nerve

A 10-year-old boy underwent surgery, a bilateral palatine tonsillectomy. During a postoperative examination, the doctor noted the boy did not possess a gag reflex on the right side on the posterior tongue. He also complained of abnormal taste sensations in the back of his oral cavity. The soft palate elevated symmetrically when the gag reflex was tested. No other signs or symptoms were noted. What cranial nerve was damaged during the tonsillectomy? Glossopharyngeal nerve Vagus nerve Trigeminal nerve Hypoglossal nerve Facial nerve

glossopharyngeal nerve

After having a tonsillectomy, a 57-year-old man with a long history of chewing tobacco use is unable to detect taste on the posterior one-third of his tongue. Which of the following nerves has most likely been injured? Lingual nerve Internal laryngeal nerve Chorda tympani Greater palatine nerve Glossopharyngeal nerve

glossopharyngeal nerve

The carotid sinus nerve is a branch of what nerve? Facial Hypoglossal Vagus Glossopharyngeal nerve

glossopharyngeal nerve

A 19-year-old woman complains of numbness of the nasopharynx after surgical removal of the adenoid. A lesion of which of the following nerves would be expected? Glossopharyngeal nerve External laryngeal nerve Vagus nerve Maxillary nerve Superior cervical ganglion

glossopharyngeal nerve (The glossopharyngeal nerve supplies sensory innervation to the mucosa of the upper pharynx)

A pharyngeal (gag) reflex is the contraction of the pharyngeal constrictor muscles that is elicited by touching the back of a patient's pharynx (e.g., with a tongue depressor). Afferent nerve fibers that innervated the pharyngeal mucosa are branches of which of the following nerves? Glossopharyngeal nerve Vagus nerve Facial nerve Hypoglossal nerve Trigeminal nerve

glossopharyngeal nerve (afferent is glosso and efferent is vegas)

The above image shows a woman with a protuberance in her neck that is associated with a lack of iodine. The swelling is called a ____________ and it results from enlargement of ___________________. Pyramidalis, thyroid gland Goiter, thyroid gland Epiglottidis, epiglottis Goiter, parathyroid gland Hyoid hypertrophy, cancer of body of hyoid bone

goiter, thyroid gland (goiter is also called thyromegaly)

A young child is evaluated by his pediatrician for chronic nosebleeds. He is referred to an allergist when it is determined that his nasal cavity is chronically dry because of a lack of glandular secretions. A possible etiology may be a lesion of which of the following structures? Lesser petrosal nerve Deep petrosal nerve Facial nerve in the facial canal Superior cervical ganglion Greater petrosal nerve

greater petrosal nerve (The parasympathetic secretomotor fibers for mucous glands in the nasal cavity run in the facial nerve, the greater petrosal nerve, the nerve of the pterygoid canal, and the pterygopalatine ganglion)

A 22-year-old patient has dryness of the corneal surface of his eye because of a lack of tears. Which of the following nerves may be damaged? Deep petrosal nerve Lesser petrosal nerve Zygomatic branch of the facial nerve Proximal portion of the lacrimal nerve Greater petrosal nerve

greater petrosal nerve The secretomotor fibers to the lacrimal gland are parasympathetic fibers that run in the facial, greater petrosal, vidian (nerve of the pterygoid canal), maxillary, zygomatic (of maxillary), zygomaticotemporal, and lacrimal (terminal portion) nerves. The lesser petrosal nerve carries secretomotor (preganglionic parasympathetic) fibers to the parotid gland. The deep petrosal nerve contains postganglionic sympathetic fibers. The zygomatic branch of the facial nerve supplies the facial muscles.

During a fight between two construction workers, one man strikes the other with a hammer at the pterion of the skull. Which of the following bones may be fractured?

greater wing of the sphenoid bone

The facial nerve supplies the muscle of mastication is the nerve of the first pharyngeal arch has 5 terminal branches runs deep to the parotid gland

has 5 terminal branches

During a difficult childbirth, a physician uses obstetric forceps to grip the infant's head as an aid to extracting her from the birth canal. However, the forceps are misapplied at the right stylomastoid foramen and crush its contents at the opening of the foramen. Which of the following ipsilateral deficits is the baby most likely to suffer? No sensation in the external acoustic meatus Reduced blood flow to the inner ear Inability to close the eyelids Inability to tense the eardrum Lack of taste on the body of the tongue

inability to close the eyelids in this case, crush injury to the facial nerve would cause a unilateral paralysis of the facial muscles including including the orbicularis oculi

The radiologic report on your 63-year-old patient stated, "possible jugular foramen syndrome." You suspected this diagnosis based on all of the following signs and symptoms except? Inability to protrude the tongue Hoarseness Inspiratory stridor Dysphagia Loss of taste from the posterior aspects of the tongue

inability to protrude the tongue The hypoglossal nerve, which innervates the genioglossus which protrudes the tongue, exits the skull via the hypoglossal canal, not via the jugular foramen. All of the other choices are consistent with lesions of CN IX, X or XI, all of which exit the skull using the jugular foramen.

A 47-year-old man cannot move his eye laterally. Which of the following conditions would cause this type of inability to move the eye? Infection in the cavernous sinus Tumor in the anterior cranial fossa Infection in the maxillary sinus Occlusion of the posterior cerebral artery Tumor of the pituitary gland

infection in the cavernous sinus

A 78-year-old man presents with signs of reduced blood flow into the right side of his face. His physician wishes to take a pulse of the facial artery on both sides to help evaluate the situation. The pulse of the facial artery can be readily palpated at which of the following locations?

inferior margin of the body of the mandible

A 47-year-old man has trouble with double vision (diplopia) after striking his head on the steering wheel in a car accident. During a subsequent eye examination, his ophthalmologist asks him to first look inward (toward his nose) and then upward (toward the ceiling). The integrity of which of the following extraocular muscles is being tested? Lateral rectus Inferior rectus Superior rectus Inferior oblique Superior oblique

inferior oblique

During preparation to extract the right maxillary (upper) canine tooth, a dentist has difficulty anesthetizing this tooth and its associated gingivae. Therefore, the dentist administers a regional nerve block, depicted in the given photo, in which the anesthetic syringe needle penetrates the oral mucosa at the apex of the maxillary vestibule and is pushed beyond the roots of the teeth. Due to this injection, the patient experiences numbness and paresthesia within the upper canine and neighboring teeth, as well as the skin of the right inferior eyelid, cheek, lateral nose, and upper lip. What nerve was blocked and produced the described numbness? External nasal Infraorbital Anterior superior alveolar Infratrochlear Nasopalatine

infraorbital nerve The infraorbital nerve is a terminal branch of the maxillary (second) division of the trigeminal nerve (CN V2). This nerve passes through the superior aspect (roof) of the maxillary sinus and emerges from the infraorbital foramen. It supplies the maxillary incisor, canine, and premolar teeth via its anterior and middle superior alveolar branches in the roof of the maxillary sinus. Ultimately, it supplies the inferior eyelid, cheek, lateral nose, and upper lip via its terminal branches in the face. In the described regional nerve block, the tip of the syringe needle is placed at the infraorbital foramen and the area is flooded with anesthetic, resulting in an infraorbital nerve block. The anesthetic agent also percolates through the thin maxillary bone to block the anterior and middle superior alveolar nerves. The infraorbital nerve is the only nerve listed, which could cause the extent of numbness and paresthesia described.

A 32-year-old woman consulted her family physician about a circumscribed, hyperpigmented swelling of the skin on the right side of her neck. The physician examined the lesion located in the lateral cervical region (posterior triangle) along the posterior border of the SCM. He was concerned when she said the nevus (mole) was gradually becoming larger. Concerned that the nevus might be a malignant melanoma, he referred her to a dermatologist. During removal, the dermatologist found that the nevus was adherent to the underlying fascia, so she performed an extensive tissue dissection. Pathological study of the nevus revealed that it was a melanoma. The skin was closed, and the patient returned home. When the patient arose the next day, she had difficulty shrugging (elevating) her right shoulder and combing her hair due to diminished ability to perform movements requiring her right upper limb to be elevated to or above the horizontal level. She called the dermatologist who asked her to come to her office. On physical examination, the physician noted drooping of her right shoulder. Which of the following statements best describes the most likely cause of the weakness of the woman's right upper limb? Injury to the vagus nerve Injury to the phrenic nerve Injury to the cervical branch of the facial nerve (CN VII) Injury to the glossopharyngeal nerve (CN IX) Injury of the spinal accessory nerve (CN XI)

injury to the spinal accessory nerve (CN XI)

A 57-year-old woman presents with right unilateral facial paralysis and dizziness. During an examination, the physician also notes a loss of hearing on the right side. An MRI of the patient's head reveals a brain tumor, as noted by the asterisk in the figure. Based upon the patient's presentation and MRI, where is the tumor located?

internal acoustic meatus

A 21-year-old woman presents to her physician with a swelling on her neck. On examination, she is diagnosed with an infection within the carotid sheath. Which of the following structures would be damaged? External carotid artery and ansa cervicalis Internal jugular vein and vagus nerve Vagus nerve and middle cervical ganglion Internal carotid artery and recurrent laryngeal nerve Sympathetic trunk and common carotid artery

internal jugular vein and vagus nerve

You previously examined a 36-year-old woman who had a large mass in her lower anterior neck. An ultrasound exam revealed it to be a benign tumor of her thyroid gland. After what should have been a simply partial thyroidectomy she is aspirating fluid into her lungs. Apparently, a nerve had been injured during the surgical procedure than innervated the upper part of her larynx. Which nerve was injured? Hypoglossal Lingual Glossopharyngeal Internal laryngeal Sympathetic trunk

internal laryngeal The internal (branch of superior laryngeal nerve) and recurrent laryngeal nerves supply the larynx with sensory innervation.

A 27-year-old woman with a goiter comes to the hospital for surgical treatment. The surgeon must ligate the superior laryngeal artery before surgically resecting the goiter, so care must be taken to avoid injury to which of the following nerves? Hypoglossal nerve Vagus nerve Superior laryngeal nerve External laryngeal nerve Internal laryngeal nerve

internal laryngeal nerve The internal laryngeal nerve accompanies the superior laryngeal artery, whereas the external laryngeal nerve accompanies the superior thyroid artery.

You are examining a child who has just swallowed a chicken bone that you suspect is lodged in his piriform recess. You are worried that the bone has pierced the mucosa and injured which nerve? Vagus nerve Hypoglossal nerve Glossopharyngeal nerve Internal laryngeal nerve External laryngeal nerve

internal laryngeal nerve (anything by the piriform recess puts danger to the internal laryngeal nerve and the superior laryngeal artery)

A 34-year-old man in a bar fight suffers a knife wound that severs the abducens nerve proximal to its entrance into the orbit. Which of the following conditions results from this injury? Ptosis of the upper eyelid Loss of visual accommodation Loss of the ability to dilate the pupil External strabismus (lateral deviation) Internal strabismus (medial deviation)

internal strabismus (medial deviation) The abducens nerve (CN VI) innervates the lateral rectus muscle, which abducts the eyeball. A lesion of the abducens nerve results in internal strabismus (medial deviation) and diplopia (double vision).

While shaving, a 75-year-old man noticed that his left superior eyelid was drooping. His wife, who was concerned that he might have had a mild stroke, insisted that he see their family physician. On examination, ptosis (drooping of the superior eyelid), miosis (contraction of the pupil), and a lack of facial sweating was detected. Which of the following statements best describes the most likely cause of the man's eye problems? Interruption of the cervical sympathetic trunk A lesion involving the parasympathetic component of CN III Injury of the levator palpebrae superioris A lesion of the facial nerve A lesion of the superior division of CN III

interruption of the cervical sympathetic trunk

What structure separates the anterior and posterior chambers in the eye? Lens Ciliary body Ora serrata Iris

iris (anterior and posterior chambers are in the anterior segment)

A 53-year-old woman with a severe middle ear infection comes to a hospital. On examination, a physician finds that the infection has injured the tympanic nerve. The damaged nerve: Is a branch of the glossopharyngeal nerve Forms the tympanic plexus in the external auditory meatus Is a branch of the facial nerve Contains postganglionic parasympathetic fibers Synapses with fibers in the lesser petrosal nerve

is a branch of the glossopharyngeal nerve

Orbicularis oris muscle is supplied by the buccal branch of CN VII is supplies by the mandibular branch of CN VII is attached to the mandible is supplied by both the buccal and the mandibular branches of CN VII

is supplied by both the buccal and the mandibular branches of CNII

During a fight, a 14-year-old boy receives an injury to the phrenic nerve from a knife wound in the neck. Which of the following anatomical relationships is correct about this nerve? It passes anterior to the anterior scalene muscle. It passes posterior to the subclavian artery. It passes deep to the brachial plexus. Anterior to the subclavian vein It passes medial to the common carotid artery.

it passes anterior to the anterior scalene muscle

A 58-year-old woman comes to a hospital and complains of progressive loss of voice, numbness, loss of taste on the back part of her tongue, and difficulty in shrugging her shoulders. Her MRI scan reveals a dural meningioma that compresses the nerves leaving the skull. These nerves leave the skull through which of the following openings?

jugular foramen

Lymph from the tonsils is conveyed to the _____________. superficial temporal node. submental node. submandibular node. parotid node. jugulodigastric node.

jugulodigastric node

A patient presents in the ER with a laceration across the right side of the neck about 1 cm (0.4 inches) deep. The cut was sutured; however, the patient was unable to raise their right arm overhead. What would best explain the limited range of motion (ROM) in the patient? Laceration of spinal accessory nerve (CNXI) Laceration of the inferior trunk of the brachial plexus Laceration of posterior scalene muscle Laceration of dorsal rami of cervical spinal nerves

laceration of spinal accessory nerve (CN XI)

A 29-year-old baseball player whose head is hit by a high-speed baseball is brought to an emergency department. Physical examination and radiogram reveal fracture of the temporal bone and damage to the lesser petrosal nerve. Which of the following conditions could occur as a result of injury to the lesser petrosal nerve? Lack of lacrimal secretion Lack of submandibular gland secretion Constriction of the pupil Lack of parotid gland secretion Ptosis of the upper eyelid

lack of parotid gland secretion

A patient goes to her dentist with her mouth fixed in an open position. She explains that after yawning, she was unable to close her mouth. Which of the following muscles most likely spasmed during the yawn causing the dislocation of her temporomandibular joint? Medial pterygoid Mentalis Temporalis Masseter Lateral pterygoid

lateral pterygoid

A 59-year-old man with a herpes zoster infection within the mandibular division of the trigeminal nerve (CN V3) complains of weakness when opening his mouth. A comprehensive evaluation reveals that his problems are due to difficulty protruding the mandible, and when protrusion is accomplished the mandible deviates to the left side, as seen in the figure. What muscle is most likely weakened? Lateral pterygoid Anterior belly of digastric Masseter Medial pterygoid Temporalis

lateral pterygoid The lateral pterygoid muscle acts on the temporomandibular joint (TMJ) to cause protrusion (or protraction) of the mandible. During the contraction of the lateral pterygoid muscle, the mandibular condyle slides anterior (translation) to be located inferior to the articular eminence of the temporal bone, which enables the mouth to open passively due to gravity. Acting unilaterally, the lateral pterygoid muscle produces side-to-side movements.

Following a very wide yawn, your 36-year-old patient found that she was unable to close her mouth. Your diagnosis is anterior dislocation of the TMJ (temporomandibular joint). The excessive contraction of which of the following muscles likely resulted in the dislocation? Masseter Buccinator Medial pterygoid Temporalis Lateral pterygoid

lateral pterygoid muscle

A 27-year-old man comes to his family physician complaining of double vision. While sitting face-to-face, the doctor notes the patient exhibits strabismus, especially esotropia of the left eye, which gives the patient a "cross-eyed" appearance. When asked to follow the doctor's index finger with only his eyes, the patient is unable to look laterally, as illustrated in the figure. No other visual deficits are noted. What specific nerve is most likely damaged? Left oculomotor nerve Left trochlear nerve Right abducent nerve Left abducent nerve Right oculomotor nerve

left abducent nerve

A 45-year-old man has hypertension (200/120 mm Hg) and hypercholesterolemia (260 mg/dl). The patient also complains of headache and dizziness. A carotid Doppler ultrasound study revealed severe stenosis of both internal carotid arteries. Bilateral carotid endarterectomies are performed. After recovery from the surgery, you notice that the patient's tongue deviates to the left upon protrusion. Which nerve was most likely injured during the surgery? Right glossopharyngeal Left vagus Left hypoglossal Right hypoglossal Left glossopharyngeal

left hypoglossal (deviates toward the injured side)

A young homeless child presents to the emergency department with high fever and low blood pressure. He had strep throat 2 weeks ago when seen in the free clinic; however, his parents could not afford antibiotic medication, and he did not take any. He now has an abscess in the auditory tube that is blocking communication between the nasopharynx and which of the following structures? Semicircular canals Inner ear Vestibule of the inner ear Middle ear External ear

middle ear

Your 1-year-old has an infection that has reached his mastoid process (mastoiditis). A classical surgical approach has been to drain the primary infection via the mastoid antrum. What is the cavity the surgeon plans to drain via this route? Inner ear Ethmoidal sinus External ear Middle ear Nasopharynx

middle ear

A 13-year-old boy competing in a motocross competition falls from his bike and sustains massive head injuries. Which of the following cavities are separated from the middle cranial fossa by a thin layer of bone? Sigmoid sinus and frontal sinus Maxillary sinus and middle ear cavity Middle ear cavity and sphenoid sinus Sphenoid sinus and ethmoid sinus Auditory tube and bony orbit

middle ear cavity and sphenoid sinus The middle ear cavity is separated from the middle cranial fossa by the tegmen tympani, a thin plate of the petrous part of the temporal bone. A part of the roof of the sphenoid bone forms the floor of the hypophyseal fossa. The other pairs of sinuses or bony cavities are not separated from the middle cranial cavity.

A 7-year-old boy was kicked in the right side of his head during a sledding accident. He arrived at the ER with no loss of consciousness but complained of a severe headache and vomiting. A computed tomography (CT) scan revealed a biconvex hyperdense extraaxial collection of blood, indicated by the arrows in the figure. What blood vessel is the most likely source of the bleed?

middle meningeal artery

A 20-year-old guard at the gate of the Royal King's palace blinks his eyes when a strong wind hits the cornea of his eye. The afferent fibers of the corneal reflex arc are carried by which of the following nerves? Optic nerve Oculomotor nerve Nasociliary nerve Zygomatic nerve Lacrimal nerve

nasociliary nerve The afferent limb of the corneal reflex arc is the nasociliary nerve, and its efferent limb is the facial nerve. The other nerves are not involved in the reflex arc. The opening of the eye is conducted by the oculomotor nerve, but it is not a part of the corneal reflex.

A dentist is about to inject a needle with an anesthetic solution into a foramen in the palate directly posterior to the space between the central incisors. What is the nerve the dentist is trying to anesthetize? Lesser palatine Posterior superior alveolar Nasopalatine Glossopharyngeal Greater palatine

nasopalatine (goes through the incisive foramen)

A 25-year-old woman is suffering from facial paralysis and exhibits ptosis (drooping of the upper eyelid). Injury to which of the following nerves would result in ptosis? Facial nerve Abducens nerve Ophthalmic nerve Oculomotor nerve Trochlear nerve

oculomotor nerve

A 56-year-old man comes to his physician complaining of an inability to open his right eye. When his doctor pries his right eye open, the right eye is directed laterally and inferiorly. What cranial nerve is most likely damaged? Oculomotor nerve Abducent nerve Trochlear nerve Facial nerve Trigeminal nerve

oculomotor nerve

During a routine eye exam, the ophthalmologist noted the direct and consensual light reflexes of his patient were absent when he shined a flashlight in the right eye. Because the doctor found no problem with the visual acuity (eyesight) of the patient, which cranial nerve is most likely damaged in this patient? Trigeminal nerve Abducent nerve Optic nerve Oculomotor nerve Trochlear nerve

oculomotor nerve

You notice that your patient has a drooping eyelid. Which of the following nerves could lead to this symptom? Long ciliary nerve Lacrimal nerve Oculomotor nerve Ciliary ganglion

oculomotor nerve

A 71-year-old woman often visits an emergency department with swallowing difficulties and subsequent choking while eating food. Which of the following pairs of muscles is most instrumental in preventing food from entering the larynx and trachea during swallowing? Musculus uvulae and geniohyoid muscles Lvevator veli palatini and tensor veli palatini muscles Inferior pharyngeal constrictor and thyrohyoid muscles Sternohyoid and sternothyroid muscles Oblique arytenoid and aryepiglottic muscles

oblique arytenoid and aryepiglottic muscles (adductors)

A 65-year-old man with multiple vision problems comes to a local eye clinic. The pupillary light reflex can be eliminated by cutting which of the following nerves? Long ciliary, optic, and short ciliary nerves Oculomotor, short ciliary, and optic nerves Ophthalmic and optic nerves and ciliary ganglion Optic and long ciliary nerves and ciliary ganglion Short ciliary, ophthalmic, and oculomotor nerves

oculomotor, short ciliary, and optic nerves

An 18-year-old male skier is brought to the emergency room after a high-speed collision with a tree. His forehead absorbed much of the impact, resulting in multiple fractures and lacerations. His ER physician noted a clear nasal discharge, which tested positive for glucose. Given the patient's presentation, what cranial nerve was most likely damaged?

olfactory nerve

As part of an initial oral examination of a new patient, a dental hygienist inspects the vestibule of the mouth. Which of the following structures is encountered in this area? Palatine tonsil Opening of the submandibular duct Uvula Lingual frenulum Opening of the parotid duct

opening of the parotid duct The vestibule of the mouth is the narrow space between the cheeks and lips and the hard wall of teeth and related gingivae (gums). The duct of the parotid gland drains into the vestibule, opposite the upper (maxillary) second molar tooth. The opening of the parotid duct can be visualized in an oral examination and readily located by the tongue.

The corneal blink response involves which of the following two nerves? Maxillary and facial Ophthalmic and oculomotor Ophthalmic and facial Maxillary and oculomotor Oculomotor and facial

ophthalmic and facial

What artery supplies the orbit and eye? Superficial temporal Ophthalmic Facial Anterior cerebral

ophthalmic artery (V1)

A 15-year-old young man developed cavernous sinus thrombophlebitis after a 1-week history of a single acne-like lesion at the anterior tip of his nose. He presented with a headache, periorbital edema, diplopia, and a fever (103°F or 39.4°C). What vein is the most likely route for the spread of this infection to the cavernous sinus? Maxillary Ophthalmic Supraorbital Great cerebral (of Galen) Superior cerebral

ophthalmic vein

The pupillary light reflex refers to the constriction of the pupil upon exposure to light. Which two cranial nerves are critical for this reflex? Oculomotor and abducent Oculomotor and ophthalmic Abducent and trochlear Optic and ophthalmic Optic and oculomotor

optic and oculomotor

A 25-year-old professional boxer loses a fight when he is rendered unconscious by his opponent. After he regains consciousness, the ringside physician notes the boxer has a severe headache, nausea, and even vomiting. Being concerned about intracranial trauma, what cranial nerve can be observed by the physician, without the aid of radiographic imaging, to gain more information on whether the boxer has increased intracranial pressure?

optic nerve

On a report of a patient with a facial laceration, you see that the ED physician noted that the patient was not able to firmly close his palpebral fissure. What is the facial muscle that was affected by the injury?

orbicularis oculi

As a result of facial injuries suffered in an automobile accident, a 17-year-old girl is unable to close her lips together tightly. Which of the following muscles is paralyzed?

orbicularis oris

A 7-year-old girl has difficulty breathing through her nose and is brought to her pediatrician. On examination, she is diagnosed with adenoids. Which of the following tonsils is enlarged? Tubal tonsil Palatine tonsil Lingual tonsil Eustachian tonsil Pharyngeal tonsil

pharyngeal tonsil

There are four parasympathetic ganglia in the head, each of which receives preganglionic fibers from a single cranial nerve. Which of the following shows the correct relationship between a parasympathetic ganglion and the cranial nerve that supplies it with preganglionic parasympathetic fibers? Pterygopalatine ganglion, maxillary nerve Submandibular ganglion, lingual nerve Otic ganglion, glossopharyngeal nerve Geniculate ganglion, facial nerve Ciliary ganglion, trochlear nerve

otic ganglion and glossopharyngeal nerve to parotid gland (not pterygopalatine ganglion and maxillary nerve because the pterygopalatine ganglion is supplied by the nerve of the pterygoid canal not maxillary nerve V2)

What muscle is tagged in this image? Styloglossus Palatopharyngeus Palatoglossus Salpingopharyngeus

palatoglossus

In the process of removing cervical lymph nodes during a radical neck dissection, a surgeon mistakenly lesions the ansa cervicalis. Which of the following deficits may occur? Reduced sensation in the skin over the posterior triangle of the neck Paralysis of the intrinsic laryngeal muscles Lymphedema in the carotid triangle of the neck Decreased blood flow to the larynx Paralysis of several infrahyoid (strap) muscles

paralysis of several infrahyoid (strap) muscles

During extraction of her impacted wisdom teeth, a 22-year-old woman suffers damage to her right inferior alveolar nerve. Which of the following conditions is most likely to result? Inability to compress the cheek Weakness in closing the jaw Decreased salivary flow Paresthesia of the lower lip Reduced taste in the body of the tongue

paresthesia of the lower lip

A 64-year-old male professional angler is diagnosed with a skin melanoma above his right eyebrow after years of excessive sun exposure. His dermatologist removes this cancerous lesion, but the doctor needs to rule out possible metastasis. What group of lymph nodes would his physician first check for possible spread of the cancer?

parotid lymph nodes The parotid lymph nodes receive lymphatic drainage from the lateral part of the anterior scalp, anterior part of the auricle, and the lateral part of the face, including the upper and lower eyelids. Due to the site of the skin melanoma above the right eyebrow, the physician must first check the parotid lymph nodes for spread of cancer.

While dissecting the posterior triangle of the neck you encounter a nerve that originates from ventral rami of cervical spinal nerves and courses along the anterior surface of the anterior scalene muscle prior to leaving the posterior triangle of the neck and entering the thorax via the superior thoracic aperture. What nerve have you encountered? Inferior root of ansa cervicalis Phrenic nerve Great auricular nerve Suprascapular accessory nerve (CNXI) Vagus nerve (CNX)

phrenic nerve

The parotid duct is superior to the zygomatic arch empties saliva into the mouth opposite the canine tooth pierces the buccinator is closely related to the medial pterygoid muscle

pierces the buccinator

The radiology report on the MRI of the brain on your 30-year-old female patient indicates the presence of "empty sella syndrome." This is a condition in which the diaphragmatic sellae is deficient and the depression within the sella turcica is largely filled with CSF. This excess fluid depresses and flattens the structure located there. What is the structure?

pituitary gland

Which of the following laryngeal muscles abducts the vocal folds? Lateral cricoarytenoid Thyroarytenoid Posterior cricoarytenoid Oblique arytenoid Transverse arytenoid

posterior cricoarytenoid

During inhalation, the action of which pair of muscles will open the rima glottides in order to facilitate laryngeal intubation? Lateral cricoarytenoids Thyroartenoids Cricothyroids Transverse arytenoids Posterior cricoarytenoids

posterior cricoarytenoids

Which sinus drains in this location? (superior meatus) Sphenoid Middle Ethmoid Posterior Ethmoid Maxillary

posterior ethmoid

A 53-year-old man has difficulty with breathing through his nose. On examination, his physician finds that he has swelling of the mucous membranes of the superior nasal meatus. Which opening of the paranasal sinuses is most likely plugged? Middle ethmoidal sinus Frontal sinus Anterior ethmoidal sinus Maxillary sinus Posterior ethmoidal sinus

posterior ethmoidal sinus

Your 43-year-old patient has a large infected swelling posterior to her sternocleidomastoid (abscess) and has dysphagia (difficulty swallowing). You suspect that the infection has penetrated what layer of the cervical fascia to enter what space? Buccopharyngeal, tracheal Investing, vertebral Prevertebral, retropharyngeal Pretracheal, carotid Alar, vertebral

prevertebral, retropharyngeal

A 34-year-old singer has been diagnosed with thyroid cancer and consequently has a thyroidectomy. He has been hoarse ever since the surgery 8 weeks ago. It has been suspected that a nerve was injured during the operation. Which of the following nerves is most likely damaged? External laryngeal nerve Internal laryngeal nerve Glossopharyngeal nerve Recurrent laryngeal nerve Hypoglossal nerve

recurrent laryngeal nerve The recurrent laryngeal nerve runs behind the thyroid gland in a groove between the trachea and esophagus and is vulnerable to injury during thyroidectomy. This nerve innervates all of the laryngeal muscles, except the cricothyroid muscle, which is innervated by the external laryngeal nerve. The internal laryngeal nerve is sensory to the larynx above the vocal cord. The hypoglossal and glossopharyngeal nerves do not supply the larynx and are not closely associated with the thyroid gland.

A newborn baby girl is unable to move her head to the right, even when her pediatrician tries to assist the movement, as seen in the photo. Her range of motion in the neck is limited in rotation and lateral bending, and her head posture is abnormally tilted toward the right and her chin is elevated and turned toward the left side. What muscle is most likely responsible for the baby's abnormal range of movement and head posture? Sternocleidomastoid Digastric Masseter Trapezius Platysma

sternocleidomastoid

The above image is an axial ultrasound scan done in the lower neck to evaluate a patient for thyroid nodules. The trachea, thyroid gland, and common carotid artery (CCA) are labeled. Based on your knowledge of anatomy, what is the structure labeled A? Sternothyroid Transverse cervical artery Ansa cervicalis Sternocleidmastoid Cricoid cartilage

sternothyroid The sternothyroid is a wide infrahyoid (strap) muscle that runs deep to the sternohyoid muscle.

Which skeletal muscle serves as a landmark for identification of the glossopharyngeal nerve? Palatoglossus Styloglossus Stylopharyngeus Palatopharyngeus

stylopharyngeus

Your 24-year-old patient has a squamous cell carcinoma of the lateral aspect of her lower lip resulting from overexposure to direct sunlight. Metastatic spread from this cancer is likely to go through which of the following groups of lymph nodes?

submandibular and deep cervical All lymph from the head and neck eventually drains to the deep cervical lymph nodes. Lymph from the lateral aspect of the lower lip first drains to the submandibular nodes.

The hypoglossal nerve and facial artery are found within the _____________. submental triangle. carotid triangle. submandibular triangle. occipital triangle. muscular triangle.

submandibular triangle

A 45-year-old man is in surgery. While seated at the head of the operating table, the anesthesiologist periodically checks the patient's pulse by palpating the artery located anterior to the tragus of the external ear. Which of the following arteries is being utilized to monitor the patient's pulse?

superficial temporal artery

A 17-year-old boy receives an injury to the phrenic nerve by a knife wound in the neck. The damaged nerve passes by which of the following structures in the neck? Superficial to the anterior scalene muscle Medial to the common carotid artery Anterior to the subclavian vein Posterior to the subclavian artery Deep to the brachial plexus

superficial to the anterior scalene muscle

A young man presents to your clinic with a 3-month history of an enlarging mass in his right neck. He undergoes a CT scan that reveals a fluid-filled mass where the common carotid artery bifurcates. Which of the following is another structure that would be located at this level? Thyroid isthmus Superior border of the thyroid cartilage Jugular notch Sternal angle Cricoid cartilage

superior border of the thyroid cartilage

The following computed tomography (CT) scan shows a left crescent-shaped extraaxial hematoma, indicated by the arrows, compressing the brain of a 17-year-old woman, who impacted the front of her head on the steering wheel during a head-on motor vehicular accident. Given the radiologic imaging results and the history of the accident, what blood vessel(s) is/are the most likely source for this cerebral hemorrhage? Superior cerebral veins Cerebral arterial circle Middle meningeal artery Superficial temporal artery Occipital artery

superior cerebral veins Following traumatic impact to the front of the head, the superior cerebral veins may be torn as they drain into the superior sagittal sinus. Tearing of the superior cerebral veins leads to a subdural (or dural border) hemorrhage, which was pictured on the provided CT.

A 42-year-old woman noticed that her right upper eyelid was drooping and her right pupil was constricted (see photo). She goes to her physician where a thorough examination revealed ptosis, miosis, anhydrosis, flushing of her face, and narrowing of the palpebral fissure (the slit between the upper and lower eyelids) on the right side of the patient. Which of the following structure is most likely damaged in this patient? Ophthalmic division of trigeminal nerve Superior division of the oculomotor nerve Nerve of the pterygoid canal Superior cervical ganglion Ciliary ganglion

superior cervical ganglion

The pupil in the eye of a 43-year-old patient remains small even when room lighting is dim. Which of the following nerves would be injured? Abducens nerve Ophthalmic nerve Oculomotor nerve Superior cervical ganglion Trochlear nerve

superior cervical ganglion

A 16-year-old girl experiences mild ptosis and miosis (pupillary constriction) in her right eye following resection of a lymphangioma from the apex of her right lung, as seen in the photo. Vision in each eye is normal. These findings are most likely due to a lesion involving which structure on the right? Thoracic posterior primary rami Thoracic anterior roots Thoracic gray rami communicantes Thoracic posterior roots Cervical posterior roots

thoracic anterior roots

Your 30-year-old patient has trigeminal neuralgia and radiofrequency ablation of the trigeminal ganglion has been recommended. The most direct route by which the surgeon will insert the electrode to perform this procedure is to insert it where?

through the foramen ovale

A majority of the course of the suprascapular artery was observed during the dissection of the scapular region; however, the origin of the artery is not revealed until one dissects the posterior triangle of the neck. What is the most common origin of the suprascapular artery? Thyrocervical trunk Costocervical trunk Vertebral artery Subclavian artery External carotid artery Common carotid artery

thyrocervical trunk

An 8-year-old boy comes to his physician with a painless and smooth mass located in the midline of his neck at the level of the hyoid bone, as noted by the arrow in the given photo. This palpable, midline neck mass was asymptomatic, but due to recent expansion, it has caused difficulty and pain when swallowing. When he swallows or protrudes his tongue, the mass moves superiorly. What is the most likely diagnosis? Branchial cyst Thyroglossal duct cyst Enlarged deep cervical lymph node Thyroid nodule Benign parathyroid adenoma

thyroglossal duct cyst A thyroglossal duct cyst is a fibrous cyst that forms within the thyroglossal duct, so it is located in, or close to, the midline of the neck. Most commonly (~50%), it is found near the body of the hyoid bone; however, the thyroglossal cyst in this patient is located inferior to this point. The thyroglossal cyst is usually painless and smooth, and this mass moves upward during swallowing or protrusion of the tongue, as reported in this patient.

Which of the following muscles is innervated by C1? Sternothyroid Anterior scalene Anterior belly of digastric Stylohyoid Thyrohyoid

thyrohyoid

What is the name of the cartilaginous prominence superior and posterior to the pharyngeal orifice of the auditory tube? Pterygoid hamulus Pharyngeal tonsil Vallate papilla Torus tubarius

torus tubarius

Your 80-year-old patient just had an embolic event that occluded all blood flowing in the central artery of the retina in her right eye. What did your patient complained of? Partial blindness in her right eye Total blindness in her right eye Dry eye Diplopia Itchy discomfort in her cornea

total blindness in her right eye

A 59-year-old man complains of numbness in the anterior cervical triangle. Therefore, damage has occurred to which of the following nerves? Greater auricular nerve Phrenic nerve Supraclavicular nerve Lesser occipital nerve Transverse cervical nerve

transverse cervical nerve The transverse cervical nerve turns around the posterior border of the sternocleidomastoid and innervates the skin of the anterior cervical triangle

The drummer of a local band presents to your clinic with hearing loss. Otoscopic examination reveals loss of contraction of the tensor tympani and the stapedius, which prevents damage to the eardrum and middle ear ossicles. These muscles are most likely controlled by which of the following nerves? Auditory and vagus nerves Chorda tympani and tympanic nerve Trigeminal and accessory nerves Facial and auditory nerves Trigeminal and facial nerves

trigeminal and facial nerves

A 67-year-old man presents with shingles on his left forehead, upper eyelid, and bridge of the nose as shown in the figure. Shingles (or herpes zoster) is caused by the varicella zoster virus, which causes chickenpox in children and young adults. After the initial chickenpox outbreak, this virus usually resides latent in sensory ganglia in the body for many years. When a patient is immunocompromised, this virus can cause shingles unilaterally along the infected nerve's dermatome distribution. What sensory ganglion is most likely affected in this patient?

trigeminal ganglion

What nerve innervates the superior oblique muscle? Trochlear (CN IV) Abducens (CN VI) Facial (CN VII) Occulomotor (CN III)

trochlear (CN IV)

A 56-year-old woman reports difficulty with diplopia (double-vision) when descending stairs. During an eye-movement exam, her right eye was unable to look downward when her eye was adducted (or in a medial position). Which of the following cranial nerves is most likely damaged in this patient's right eye? Trochlear nerve Abducent nerve Facial nerve Oculomotor nerve Trigeminal nerve

trochlear nerve

Your 61-year-old diabetic patient is complaining of vertical diplopia, especially while trying to read. You do an eye muscle testing exam and determine that the right superior oblique muscle is weak. You thus believe which of the following nerves was affected by his diabetes? Ophthalmic Troclear Oculomotor Abducent Optic

troclear nerve

Your 53-year-old patient is suffering from hyperacusia (excessive acuteness of hearing). What is this condition most likely associated with? Lesion of the chorda tympani Otitis media Blockage of the pharyngotympanic tube Increased endolymphatic pressure Tumor of the facial nerve at the internal acoustic meatus

tumor of the facial nerve at the internal acoustic meatus Paralysis of the stapedius muscle in the middle ear results in hyperacusia. This muscle is innervated by the facial nerve.

If normal evagination of the endodermal lining of the embryonic pharynx does not take place between the pharyngeal (branchial) arches, the pharyngeal (branchial) pouches will not form. Maldevelopment of the first pharyngeal pouch during embryonic weeks 4 to 5 is most likely to result in a congenital disorder of which of the following structures? Thymus gland Parathyroid glands Thyroid gland Facial muscles Tympanic cavity

tympanic cavity