Chapter 7 - Head

Which of the following is incorrect pertaining to the soft palate? A.) It extends inferiorly as the palatine tonsil. B.) It is composed of both aponeurotic and muscular parts. C.) It is tensed against the posterior wall of the pharynx during swallowing. D.) It is tensed by a muscle that uses the pterygoid hamulus as a pulley. E.) It is provided with sensory innervation via the lesser palatine nerve.

A.) It extends inferiorly as the palatine tonsil.

Which of the following is incorrect pertaining to the CSF? A.) It returns to the venous system by passing into the vertebral venous plexuses. B.) It provides some cushioning to the brain when the skull is struck. C.) Samples are typically obtained in infants through needle puncture into the posterior cerebellomedullary cistern. D.) Overproduction results in hydrocephalus. E.) Fractures of the floor of the middle cranial fossa may result in leakage through the external acoustic meatus

A.) It returns to the venous system by passing into the vertebral venous plexuses.

Which of the following is incorrect pertaining to fontanelles? A.) The remains of the anterior fontanelle is often indicated by the metopic suture. B.) A bulging fontanelle indicates excessive intracranial pressure. C.) They facilitate molding. D.) Lambda indicates the site of the posterior fontanelle. E.) Fontanelles are normally not palpable after 18 months of age.

A.) The remains of the anterior fontanelle is often indicated by the metopic suture.

You examine a comatose patient in the emergency room. His wife relates that her husband was struck accidentally in his "temple" by a baseball. After an initial period of unconsciousness, he seemed to be okay but later became drowsy and comatose. You suspect that the patient is suffering from: A.) an extradural (epidural) hematoma caused by a laceration of a branch of the middle meningeal artery. B.) a subdural hematoma caused by a laceration of a branch of the middle meningeal artery. C.) an extradural (epidural) hematoma caused by a laceration of the transverse venous sinus. D.) a subdural hematoma caused by a laceration of a branch of the transverse venous sinus. E.) a subarachnoid hemorrhage caused by a laceration of the internal carotid artery.

A.) an extradural (epidural) hematoma caused by a laceration of a branch of the middle meningeal artery.

Which of the following associations pertaining to the dural venous sinuses is incorrect? A.) arachnoid granulations—calcifications of arachnoid mater within the sinuses associated with arteriosclerosis B.) confluence of the sinuses—near internal occipital protuberance C.) inferior sagittal sinus—located within the falx cerebri D.) sigmoid sinus—continues inferiorly as internal jugular vein E.) occipital sinus—metastases via internal vertebral venous plexuses

A.) arachnoid granulations—calcifications of arachnoid mater within the sinuses associated with arteriosclerosis

The abnormality shown in the following illustration is called: A.) cleft lip. B.) split lip. C.) separated lip. D.) canine separation. E.) incisor hiatus.

A.) cleft lip.

In complete oculomotor nerve palsy, the pupil is: A.) depressed and abducted. B.) elevated and abducted. C.) depressed and adducted. D.) elevated and adducted. E.) fixed in a neutral position.

A.) depressed and abducted.

Injection of an anesthetic agent into the infraorbital foramen would eliminate sensation from all of the following regions/structures except the: A.) hard palate. B.) anterior maxillary teeth. C.) upper lip. D.) upper gum. E.) philtrum.

A.) hard palate.

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, you would put pressure on the: A.) horizontal ramus of the mandible just anterior to the attachment of the masseter. B.) horizontal ramus of the mandible directly inferior to the angle of the mouth. C.) infraorbital foramen. D.) lateral aspect of mastoid process. E.) coronoid process of the mandible.

A.) horizontal ramus of the mandible just anterior to the attachment of the masseter.

Which of the following is not associated with the frontal bone(s)? A.) malar flush B.) glabella C.) metopic suture D.) supraorbital foramen E.) roof of the orbit

A.) malar flush

The muscle primarily responsible for producing the mouth posture shown in the following figure is: A.) orbicularis oris. B.) risorius. C.) zygomaticus major. D.) buccinator. E.) levator labii superioris.

A.) orbicularis oris.

Blockage of the central artery of the retina due to an embolus is associated with: A.) total and immediate blindness. B.) partial blindness (loss of central vision). C.) glaucoma. D.) papilledema. E.) initial blindness followed by slow recovery, assuming that collateral circulation is provided by the ciliary arteries.

A.) total and immediate blindness.

In the emergency department you examine a patient complaining of severe maxillary sinus pain. Upon looking in his mouth, you observe severely degenerated maxillary molars. The patient admits that he has not been treated by a dentist for many years and recently had an upper posterior toothache. Which of the following is the most likely cause of the patient's pain? A.) An infection from an upper molar has spread along the inferior alveolar nerve to the maxillary sinus. B.) An infection has spread via the root of an upper maxillary molar into the maxillary sinus. C.) Poor dental hygiene has resulted in alveolar bone retraction with accompanying fracture of a tooth and invasion of the maxillary sinus by oral bacteria. D.) Poor dental hygiene has caused the root of a maxillary molar to break and invade the maxillary sinus. E.) Poor dental hygiene has weakened the maxillary facial buttress causing both the toothache and sinus pain.

B.) An infection has spread via the root of an upper maxillary molar into the maxillary sinus.

Which of the following is not true of the nasal septum? A.) It forms the medial wall of the nasal cavity. B.) It is attached to the inferior nasal concha. C.) It has bony and cartilaginous parts. D.) It attaches to the cribriform plate superiorly. E.) It is partly innervated by the nasopalatine nerve

B.) It is attached to the inferior nasal concha.

Which of the following is incorrect pertaining to the scalp? A.) Superficial wounds do not gape because the margins of the wound are held together by the epicranial aponeurosis. B.) The scalp muscles (e.g., occipitofrontalis) are attached to the pericranium. C.) Blood vessels and nerves enter the scalp inferiorly. D.) Scalp infections may spread to the brain via emissary veins that pass through parietal foramina. E.) Scalp injuries can result in "black eyes."

B.) The scalp muscles (e.g., occipitofrontalis) are attached to the pericranium.

Which of the following is incorrect pertaining to the lips? A.) They are attached by frenula to the vestibular gingiva. B.) The upper and lower lips receive sensory innervation via the infraorbital nerve. C.) Both lips receive blood via branches from the facial artery. D.) Lymph from the lips drain to the submandibular and submental lymph nodes. E.) They contain the orbicularis oris muscle.

B.) The upper and lower lips receive sensory innervation via the infraorbital nerve.

To anesthetize all of the mandibular teeth but not the tongue, you would place the needle of the syringe: A.) at the inferior opening of the foramen ovale. B.) at the opening of the mandibular canal. C.) at the opening of the mental foramen. D.) at the otic ganglion. E.) on the posterior aspect of the maxilla in the infratemporal fossa.

B.) at the opening of the mandibular canal.

In the carotid arteriogram below, the location of the internal carotid artery at the site indicated by the arrow is in the: A.) substance of the brain. B.) cavernosus sinus. C.) petrous part of the temporal bone. D.) foramen lacerum. E.) maxillary sinus.

B.) cavernosus sinus.

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? A.) lesion of the right nasociliary nerve B.) compression of the right oculomotor nerve C.) compression of the right facial nerve proximal to the geniculate ganglion D.) compression of the right facial nerve distal to the geniculate ganglion E.) lesion of the left long ciliary nerves

B.) compression of the right oculomotor nerve

The arrow in the following photograph points to the: A.) limbus. B.) conjunctival fornix. C.) lacrimal punctum. D.) lacrimal lake. E.) orbital recess.

B.) conjunctival fornix.

Presbyopia refers to the loss of: A.) transparency of the lens. B.) focusing power of the lens. C.) the pupillary light reflex. D.) coordination between the two eyes. E.) coordination between the extraocular muscles.

B.) focusing power of the lens.

In the following illustration of a dissection of the infratemporal region, the arrow points to the: A.) lingual nerve. B.) inferior alveolar nerve. C.) chorda tympani. D.) buccal nerve. E.) masseteric nerve.

B.) inferior alveolar nerve.

In the following figure, what structure traverses the foramen indicated by the arrow? A.) internal jugular vein B.) internal carotid artery C.) basilar artery D.) vagus nerve E.) mandibular nerve

B.) internal carotid artery

Hyperacusia would be associated with: A.) lesion of the chorda tympani. B.) lesion of the facial nerve at the internal acoustic meatus. C.) otitis media. D.) blockage of the pharyngotympanic tube. E.) increased endolymphatic pressure.

B.) lesion of the facial nerve at the internal acoustic meatus.

You are assisting an oral surgeon who is about to remove a calculus (stoma) 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. You reply: A.) spinal accessory. B.) lingual. C.) chorda tympani. D.) internal laryngeal. E.) glossopharyngeal.

B.) lingual.

A late nineteenth century technique to treat trigeminal neuralgia was to inject alcohol into the trigeminal ganglion, which destroys all of the sensory fibers in the ganglion. Once the procedure was successfully implemented, the patient would: A.) be unable to chew. B.) lose sensation from all areas of his face except the area overlying the parotid gland and some of the auricle C.) lose sensation from just the area overlying the body and ramus of the mandible. D.) lose sensation from just the midface area. E.) lose all sensation from his tongue.

B.) lose sensation from all areas of his face except the area overlying the parotid gland and some of the auricle

In the following photograph of a view through an ophthalmoscope, the arrow points to the: A.) macula. B.) optic disc. C.) fovea centralis. D.) light reflex. E.) lens.

B.) optic disc.

In the following sagittal MRI, the arrow points to the: A.) levator palpebrae superioris. B.) superior rectus. C.) superior oblique. D.) superior ophthalmic artery. E.) facial artery.

B.) superior rectus.

You examine a patient with localized meningitis in the middle cranial fossa. The meningitis is believed to be secondary to otitis media. The most likely route by which the infection spread is through the: A.) floor of the tympanic cavity. B.) tegmen tympani. C.) labyrinthine (medial) wall of the tympanic cavity. D.) tympanic membrane. E.) pharyngotympanic tube.

B.) tegmen tympani.

Which one of the following conditions would be most consistent with the definition of a "blowout" fracture of the orbit? A.) orbital fat becoming displaced into frontal sinus B.) the inferior oblique muscle becoming displaced into the maxillary sinus C.) all of the recti muscles becoming detached from their bony attachments D.) the superior oblique muscle losing its attachment to the trochlea E.) exophthalmos

B.) the inferior oblique muscle becoming displaced into the maxillary sinus

A late nineteenth century technique to treat trigeminal neuralgia was to inject alcohol into the trigeminal ganglion, which destroys all of the sensory fibers in the ganglion. The most likely (direct) method by which the surgeon performed this procedure was to insert a needle: A.) through the infraorbital foramen. B.) through the foramen ovale. C.) under the eyeball through the inferior orbital fissure. D.) through the pterygomaxillary fissure. E.) through the nasal cavity.

B.) through the foramen ovale.

Which of the following is incorrect pertaining to the muscles of mastication? A.) They are all innervated by the motor division of the trigeminal nerve. B.) The temporal, masseter, and medial pterygoid all can close the mouth. C.) Alternating contraction of the temporalis muscle can produce rotary movements. D.) Two of them attach to the lateral pterygoid plate. E.) The masseter can protrude the mandible.

C.) Alternating contraction of the temporalis muscle can produce rotary movements.

While waiting to assist a neurologist who is about to perform a lumbar puncture, she asks you to conduct an eye exam on the patient. Why? A.) Because a CSF infection would be revealed by a discoloration in the anterior chamber of the eye. B.) Because slowness in pupillary dilation would indicate reduced CSF pressure. C.) Because papilledema would indicate increased CSF pressure. D.) Because retinal arterial sprouting would indicate arterial leakage into the CSF. E.) Because swelling of the ophthalmic veins would indicate increased CSF pressure.

C.) Because papilledema would indicate increased CSF pressure.

Which of the following is not correct for the cribriform plate? A.) It is part of the ethmoid bone. B.) It possesses numerous tiny foramina that transmit olfactory nerves. C.) It is located in the middle cranial fossa. D.) It lies adjacent to the crista galli. E.) It is located posterior to the frontal crest.

C.) It is located in the middle cranial fossa.

Which of the following is correct pertaining to using an otoscope? A.) In infants and adults, the helix is pulled posterosuperiorly to reduce the curvature of the external acoustic meatus. B.) The tympanic membrane is typically transparent. C.) The handle of malleus is usually visible near the umbo. D.) Any light reflex from the otoscope's bulb indicates an abnormality. E.) It is normal to observe an amber (bloody) colored fluid in the tympanic cavity.

C.) The handle of malleus is usually visible near the umbo.

All lymphatic vessels from the head and neck drain directly or indirectly into lymph nodes located: A.) at the junction of the internal jugular and subclavian veins. B.) along the subclavian vein. C.) along the internal jugular vein. D.) along the external jugular vein. E.) along the anterior jugular vein.

C.) along the internal jugular vein.

Pulsating exophthalmos is associated with: A.) tear of the lacrimal artery. B.) tear of the inferior ophthalmic vein. C.) arteriovenous fistula within the cavernous sinus. D.) rupture of the pterygoid venous plexus. E.) section of the oculomotor nerve.

C.) arteriovenous fistula within the cavernous sinus.

In the following coronal CT, the arrow points to the: A.) superior concha. B.) sphenoid sinus. C.) ethmoid sinus. D.) nasopharynx. E.) infundibulum.

C.) ethmoid sinus.

During a difficult delivery an obstetrician uses forceps to extract the infant. Upon examining the baby you notice forceps impressions posteroinferior to the ear. You are most concerned that the: A.) forceps may have penetrated a fontanelle. B.) middle ear cavity may have been crushed. C.) facial nerve may have been injured. D.) mastoid process may have been avulsed. E.) styloid process and associated muscles may have been avulsed.

C.) facial nerve may have been injured.

Which of the following signs would be consistent with Bell palsy? A.) inability to raise the upper eyelid B.) loss of the tympanic reflex C.) food dribbling from the corners of the mouth D.) loss of ability to protrude the tongue E.) loss of ability to focus on near objects

C.) food dribbling from the corners of the mouth

Which one of the following nerves does not have a relationship with the parotid gland or its sheath? A.) auriculotemporal nerve B.) facial nerve C.) glossopharyngeal nerve D.) great auricular nerve E.) chorda tympani

C.) glossopharyngeal nerve

The gag reflex can be initiated by touching the posterior aspect of the tongue. The nerve responsible for conducting the afferent part of this reflex is the: A) lingual. B.) vagus. C.) glossopharyngeal. D.) hypoglossal. E.) pinnal accessory.

C.) glossopharyngeal.

The cerebellar tentorium: A.) is composed of arachnoid matter. B.) contains CSF. C.) has a tough edge that may lesion the oculomotor nerve during tentorial herniation. D.) may become occluded, resulting in loss of blood supply to the cerebellum. E.)may produce headaches associated with pituitary tumors.

C.) has a tough edge that may lesion the oculomotor nerve during tentorial herniation.

Following partial thyroidectomy a patient presents with signs and symptoms that you believe indicate his cervical sympathetic trunk was inadvertently transected during the procedure. Which of the following would not be consistent with your suspicion? A.) pupillary constriction B.) ptosis C.) inability to firmly close the eyelids D.) absence of sweating on the forehead E.) redness and increased temperature on the forehead

C.) inability to firmly close the eyelids

Which of the following associations pertaining to the parotid gland is incorrect? A.) parotid duct—opens opposite upper 2nd molar B.) mumps—swelling of the parotid gland C.) parotid sialogram—metastasis from a parotid tumor D.) blockage of the parotid duct—pain upon sucking a lemon E.) accessory parotid gland—drains into the parotid duct

C.) parotid sialogram—metastasis from a parotid tumor

The choanae: A.) are attached to the maxilla. B.) are attached to the ethmoid. C.) provide a passageway from the nasopharynx to the nasal cavity. D.) provide a passageway between the nasopharynx and the oropharynx. E.) provide an attachment for the tensor veli palatini.

C.) provide a passageway from the nasopharynx to the nasal cavity.

The chorda tympani nerve supplies: A.) motor innervation to the intrinsic muscles of the tongue. B.) motor innervation to the extrinsic muscles of the tongue. C.) sensory innervation to the fungiform papillae located at the apex of the tongue. D.) sensory innervation to the posterior third of the tongue. E.) sensory innervation to the epiglottis.

C.) sensory innervation to the fungiform papillae located at the apex of the tongue.

Which of the following is incorrect pertaining to the vestibular labyrinth? A.) It is composed of the saccule, the utricle, and the semicircular canals. B.) Its macula contains otoliths. C.) Its macula is innervated by the vestibulocochlear nerve. D.) Diseases result in Ménière syndrome. E.) It contains endolymph.

D.) Diseases result in Ménière syndrome.

Excessive contraction of both lateral pterygoid muscles may result in: A.) fracture of the angle of the mandible. B.) fracture of the coronoid process of the mandible. C.) lateral dislocation of one mandibular condyle and medial dislocation of the other. D.) anterior dislocation of condyles of the mandible. E.) posterior dislocation of the condyles of the mandible.

D.) anterior dislocation of condyles of the mandible.

Ophthalmic herpes zoster is characterized by: A.) inability to raise the upper eyelid. B.) inability to abduct the eye. C.) inability to focus on near objects. D.) corneal ulceration. E.) loss of sensation from the forehead.

D.) corneal ulceration.

Vallate papillae are taste receptors located: A.) on the hard palate. B.) on the soft palate. C.) on the tip of the tongue. D.) directly anterior to the terminal sulcus on the tongue. E.) on the epiglottis.

D.) directly anterior to the terminal sulcus on the tongue.

Which of the following is not a foramen or fissure in the sphenoid bone? A.) superior orbital B.) rotundum C.) ovale D.) lacerum E.) spinosum

D.) lacerum

In which of the following areas of the nasal cavity would you look to determine whether the ostium of the maxillary sinus is obstructed? A.) vestibule B.) atrium C.) inferior meatus D.) middle meatus E.) superior to the opening of the auditory tube

D.) middle meatus

The pterion: A.) is posteroinferior to the external acoustic meatus. B.) is part of the sphenoid bone. C.) is part of the temporal bone. D.) overlies the anterior branch of the middle meningeal artery. E.) is located at the junction of the sagittal and coronal sutures.

D.) overlies the anterior branch of the middle meningeal artery.

What structure traverses the groove indicated by the arrow in the following figure? A.) internal carotid artery B.) internal jugular vein C.) middle meningeal artery D.) sigmoid sinus E.) transverse sinus

D.) sigmoid sinus

The arrow in the following figure indicates the location of which of the following cranial bones? A.) maxilla B.) frontal C.) ethmoid D.) sphenoid E.) zygomatic

D.) sphenoid

Which of the following associations pertaining to the eyes is incorrect? A.) ptosis—damage to the oculomotor nerve B.) "pinkeye"—inflammation of the conjunctiva C.) superior conjunctival fornix—receives lacrimal fluid (tears) D.) tear drainage—via nasolacrimal duct to middle meatus of nose E.) stimulation of tear production—greater petrosal nerve

D.) tear drainage—via nasolacrimal duct to middle meatus of nose

In the following lateral radiograph, the arrow points to: A.) a coronal suture. B.) a skull fracture. C.) a vessel in the temporalis muscle. D.) the groove for the middle meningeal artery. E.) the edge of the greater wing of sphenoid bone.

D.) the groove for the middle meningeal artery.

Which of the following is incorrect pertaining to the pterygopalatine ganglion? A.) It receives preganglionic parasympathetic fibers via the greater petrosal nerve. B.) Sympathetic fibers reach it via the deep petrosal nerve. C.) If stimulated, tearing of the eyes and nasal secretions occur. D.) Both sympathetic and parasympathetic fibers travel through the pterygoid canal to reach it. E.) The ganglion contains the cell bodies of the postganglionic sympathetic neurons.

E.) The ganglion contains the cell bodies of the postganglionic sympathetic neurons.

Which of the following associations is incorrect pertaining to the blood supply of the brain? A.) middle cerebral artery—supplies the lateral surface of the brain B.) anterior communication artery—connects anterior cerebral arteries C.) hemorrhagic stroke—severe headache and stiff neck D.) cerebral arterial circle (circle of Willis)—an anastomosis between the two vertebral and two internal carotid arteries E.) cerebral arterial circle (circle of Willis)—in most cases prevents development of neurological symptoms following acute ischemic stroke

E.) cerebral arterial circle (circle of Willis)—in most cases prevents development of neurological symptoms following acute ischemic stroke

Which of the following is not correct pertaining to the cavernous sinus? A.) traversed by the internal carotid artery B.) located on either side of the sella turcica C.) may become thrombosed via infections in the superior part of the face D.) septic thrombosis can lead to the development of meningitis E.) contains the mandibular division of the trigeminal nerve

E.) contains the mandibular division of the trigeminal nerve

The "blind spot" of the eye refers to the: A.) macula lutea. B.) uvea. C.) fovea centralis. D.) choroid. E.) optic disc.

E.) optic disc.

Which of the following regions does not communicate with the pterygopalatine fossa via the indicated route? A.) infratemporal fossa via pterygomaxillary fissure B.) nasal cavity via the sphenopalatine foramen C.) orbit via the inferior orbital fissure D.) middle cranial fossa via foramen rotundum E.) sphenoid sinus via the pterygoid canal

E.) sphenoid sinus via the pterygoid canal

You examine a patient in the emergency department following a bee sting to the bridge of her nose. Both of the patient's eyes are swollen shut because: A.) the sting interfered with the nerve that raises the eyelid. B.) the sting blocked lymph drainage from the region. C.) the face is characterized by very cutaneous veins that ruptured from the sting. D.) the face is characterized by very cutaneous arteries that ruptured from the sting. E.) the face is characterized by very loose subcutaneous connective tissue that allows accumulation of excessive fluid with inflammation.

E.) the face is characterized by very loose subcutaneous connective tissue that allows accumulation of excessive fluid with inflammation.