Neuro exam 2

A 45-year-old man was riding his bicycle when he swerved to avoid a pot hole and lost his balance. He crashed, hitting his head against a rock. When he regained consciousness in the emergency department of a neighboring hospital, it was immediately noted that he had medial strabismus (squint) of his right eye. Which nerve was injured by the crash? A. Abducens nerve B. Facial nerve C. Oculomotor nerve D. Ophthalmic division of the trigeminal nerve E. Trochlear nerve

A. Abducens nerve

A functional impediment to the act of swallowing probably would NOT result from damage to which of the following nerves? A. Abducens nerve B. Buccal branch of the facial nerve C. Hypoglossal nerve. D. Mandibular division of the trigeminal nerve E. Vagus nerve

A. Abducens nerve

An aged medical professor comes to you for a diagnosis with the complaint of double vision. Although you are quite sure that his vision problem was responsible for the poor grade you received in your medical school course he taught, you agree to examine him. Your examination reveals that when asked to look to the far left, his left eye is slightly elevated compared to the right eye, and when asked to look straight down at the floor, his left eye is adducted as well as depressed. Which nerve is likely involved in this lesion involving the left eye? A. Abducens nerve B. Oculomotor nerve C. Ophthalmic nerve D. Optic nerve E. Trochlear nerve

A. Abducens nerve

Eye examination reveals symmetric pupils in a patient that react normally to accommodation and light. When the patient looks straight ahead, the eyes are normally situated. The patient is unable to look lateral to the midline with his left eye when you tell him to look to the left, although the right eye turns normally toward the midline. All other extraocular muscles and movements are intact. The rest of the examination is normal. What cranial nerve is the likely cause of this patient's findings? A. Abducens nerve B. Facial nerve C. Oculomotor nerve D. Trigeminal nerve E. Trochlear nerve

A. Abducens nerve

Bell palsy can involve corneal inflammation and subsequent corneal ulceration. Which of the following best describes the reason for these clinical events? A. Absence of the blinking reflex due to paralysis of the muscles that close the eyelid B. Absence of the blinking reflex due to paralysis of the muscles that open the eyelid C. Constriction of the pupil due to paralysis of the dilator pupillae D. Lack of secretion of the salivary glands E. Sensory loss of the cornea and conjunctiva

A. Absence of the blinking reflex due to paralysis of the muscles that close the eyelid

A small tumor in the superior orbital fissure causes disruption of the oculomotor nerve. Which of the following clinical signs would NOT be present in the patient? A. Absence of the corneal reflex B. Absence of the pupillary light reflex C. Dilation of the pupil D. Eye turned 'down and out' E. Ptosis

A. Absence of the corneal reflex

A penetrating wound to the right posterior triangle of the neck resulted in the patient's inability to raise their right hand above their head. What structure was damaged? A. Accessory nerve B. Lower roots of brachial plexus C. Omohyoid muscle D. Supraclavicular nerves E. Transverse cervical nerves

A. Accessory nerve

A young man was slashed deeply with a knife in the middle of the right posterior triangle of the neck. The cut ended anterior to the middle of the SCM. The bleeding was arrested and the wound was sutured. The patient, who was right-handed, later complained that he had difficulty combing his hair and tilting his head to the right. Injury to what large nerve was responsible for the difficulty in combing his hair and tilting his head to the right? A. Accessory nerve B. Axillary nerve C. Lesser occipital nerve D. Supraclavicular nerves E. Transverse cervical nerves

A. Accessory nerve

Following removal of a malignant tumor from the right posterosuperior region of the neck of a 52-year-old man, the surgeon decided to do a radical neck dissection of the region to remove enlarged lymph nodes. One enlarged lymph node was in the submandibular triangle, deep to the superior end of the sternocleidomastoid muscle. After the operation, the man informed the surgeon that he had difficulty shrugging his right shoulder and turning his face to the left side against resistance. What nerve was probably injured during the surgical removal of the enlarged lymph nodes? A. Accessory nerve B. Great auricular nerve C. Lesser occipital nerve D. Supraclavicular nerve E. Transverse cervical nerve

A. Accessory nerve

What component of the cervical plexus provides motor innervation to the infrahyoid muscles? A. Ansa cervicalis B. Greater auricular nerve C. Lesser occipital nerve D. Supraclavicular nerves E. Transverse cervical nerves

A. Ansa cervicalis

What nerves innervate the infrahyoid muscles? A. Ansa cervicalis B. Cervical branches of the facial nerve C. Postganglionic sympathetic fibers from the cervical ganglia D. Suprascapular nerves E. Transverse cervical nerves

A. Ansa cervicalis

Fracture of the nasal bones may result in rupture and hemorrhage from which artery? A. Anterior ethmoidal artery B. Posterior ethmoidal artery C. Septal branches of the greater (anterior) palatine artery D. Septal branches of the sphenopalatine artery E. Septal branches of the superior labial branches of the facial artery

A. Anterior ethmoidal artery

Which of the following areas of the head does NOT receive sensation from the maxillary nerve? A. Anterior two-thirds of the tongue B. Mucosa of the hard palate C. Mucosa of the maxillary sinuses D. Nasal mucosa E. Skin overlying the cheeks

A. Anterior two-thirds of the tongue

What is the first resistant structure that can be palpated in the midline of the neck inferior to the chin? A. Body of the hyoid bone B. Cricoid cartilage C. Laryngeal prominence of the thyroid cartilage D. Superior horn of the thyroid cartilage E. Tracheal cartilage

A. Body of the hyoid bone

What cranial nerve gives rise to nerve fibers that innervate the anterior two-thirds of the tongue for general sensation? A. CN V3 B. CN VII C. CN IX D. CN X E. CN XII

A. CN V3

A patient is brought into the emergency department with an attack of paroxysmal tachycardia. The resident physician restores the heart to normal sinus rhythm by simple massage of the region superficial to the carotid sinus. What nerve whose excessive activity may contribute to tachycardia? A. Cardiac nerves arising from the cervical sympathetic chain B. Glossopharyngeal nerves C. Hypoglossal nerves D. Inferior roots of the ansa cervicalis E. Vagus nerves

A. Cardiac nerves arising from the cervical sympathetic chain

Which of the following structures is NOT enclosed by the carotid sheath? A. Cervical sympathetic trunk B. Common carotid artery C. Internal carotid artery D. Internal jugular vein E. Vagus nerve

A. Cervical sympathetic trunk

Where is the location of the nerve cell bodies that give rise to postganglionic axons that supply parasympathetic innervation to the ciliary muscle? A. Ciliary ganglion B. Geniculate ganglion C. Pterygopalatine ganglion D. Superior cervical ganglion E. Trigeminal ganglion

A. Ciliary ganglion

In the course of administrating a local anesthetic, a needle that is placed too far into the greater palatine canal may paralyze an autonomic ganglion. In addition to dry nasal mucosa from loss of nasal gland secretion, what additional loss of function at this ganglion would result? A. Dry eye from loss of lacrimal gland secretion B. Dry mouth from loss of parotid gland secretion C. Dry mouth from loss of submandibular and sublingual gland secretions. D. Ptosis E. Pupillary constriction

A. Dry eye from loss of lacrimal gland secretion

What nerve innervates the cricothyroid muscle? A. External branch of the superior laryngeal B. Glossopharyngeal C. Internal branch of the superior laryngeal D. Pharyngeal plexus E. Recurrent laryngeal

A. External branch of the superior laryngeal

A 10-year-old boy was admitted to the hospital with a sore throat and earache. He had a high fever (temperature, 40.5o C), rapid pulse rate, and rapid respirations. Examination of the boy's throat by the attending physician revealed diffuse redness and swelling of the pharynx, especially of the palatine tonsils. His left tympanic membrane was also bulging. The boy's medical history revealed that he had had chronic symptoms of inflammation of the nasal mucous membrane (rhinitis), including the pharyngeal tonsils (adenoiditis), resulting in persistent mouth breathing. On one occasion he had had a peritonsillar abscess (quinsy). A branch of which arterial blood vessel supplies the tonsillar region? A. Facial artery B. Lingual artery C. Occipital artery D. Superior thyroid artery E. Vertebral artery

A. Facial artery

What artery serves as the primary blood supply to the submandibular gland? A. Facial artery B. Lingual artery C. Occipital artery D. Posterior auricular artery E. Superior thyroid artery

A. Facial artery

What nerve is responsible for the efferent limb of the blink reflex? A. Facial nerve B. Glossopharyngeal nerve C. Mandibular nerve D. Maxillary nerve E. Vagus nerve

A. Facial nerve

A 10-year-old boy was admitted to the hospital with a sore throat and earache. He had a high fever (temperature, 40.5o C), rapid pulse rate, and rapid respirations. Examination of the boy's throat by the attending physician revealed diffuse redness and swelling of the pharynx, especially of the palatine tonsils. His left tympanic membrane was also bulging. The boy's medical history revealed that he had had chronic symptoms of inflammation of the nasal mucous membrane (rhinitis), including the pharyngeal tonsils (adenoiditis), resulting in persistent mouth breathing. On one occasion he had had a peritonsillar abscess (quinsy). What nerve supplies the tonsillar area and the tympanic membrane? A. Glossopharyngeal nerve B. Hypoglossal nerve C. Spinal accessory nerve D. Trigeminal nerve E. Vagus nerve

A. Glossopharyngeal nerve

What is the usual site to perform an emergency cricothyrotomy to relieve airway obstruction? A. In the midline through the cricothyroid membrane B. In the midline through the thyrohyoid membrane C. Just above the laryngeal prominence D. Just above the suprasternal (jugular) notch E. Laterally through the thyrohyoid membrane

A. In the midline through the cricothyroid membrane

Which of the following statements is CORRECT regarding the major arterial supply to the nasal cavity? A. It enters the nasal cavity through the sphenopalatine foramen located just behind the posterior aspect of the middle conchae. B. It enters the nose through the cribriform plate of the ethmoid. C. It enters the nose through the incisive foramen. D. It is a branch of the ophthalmic artery. E. It is a branch of the superficial temporal artery.

A. It enters the nasal cavity through the sphenopalatine foramen located just behind the posterior aspect of the middle conchae.

A 30-year-old woman was concerned about a swelling in the anterior part of her neck, nervousness, and loss of weight. She told her family physician that her family complains that she is irritable, excitable, and cries easily. A swelling was detected on each side of her neck inferior to the larynx. During palpation of the patient's neck from a posterior position, the physician felt an enlarged thyroid gland and noted that it moved up and down during swallowing. The following signs were also detected: protrusion of the eyes, rapid pulse, tremor of the digits, moist palms, and loss of weight. What other gland may be injured with thyroidectomy? A. Parathyroid gland B. Pineal gland C. Pituitary gland D. Submandibular gland E. Thymus

A. Parathyroid gland

The brachial plexus passes between which two cervical muscles? A. Scalenus anterior and scalenus medius B. Scalenus medius and levator scapulae C. Scalenus medius and scalenus posterior D. Scalenus posterior and levator scapulae E. Scalenus posterior and splenius capitis

A. Scalenus anterior and scalenus medius

The true vocal cords extend between what structures? A. Arytenoid and epiglottic cartilages B. Arytenoid and thyroid cartilages C. Corniculate and thyroid cartilages D. Cricoid and thyroid cartilages E. Cuneiform and cricoid cartilages

B. Arytenoid and thyroid cartilages

The superior border of the thyroid cartilage serves as a landmark for what structure? A. Attachment of the thyrohyoid muscle B. Bifurcation of the common carotid artery C. Beginning of the esophagus D. Location of the upper pole of the thyroid gland E. Site for doing a cricothyrotomy

B. Bifurcation of the common carotid artery

Into what sinus do the superior and inferior ophthalmic veins drain? A. Basilar sinus B. Cavernous sinus C. Inferior sagittal sinus D. Straight sinus E. Superior sagittal sinus

B. Cavernous sinus

A 59-year-old woman was seen by her physician with a small swelling below her chin. On examination, a single hard swelling could be palpated in the submental triangle. It was mobile on the deep tissues and not tethered to the skin. A diagnosis of a malignant secondary deposit in a submental lymph node was considered. Using your knowledge of anatomy, where would you look for the primary carcinoma? A. Angle of mouth B. Center of the lower lip C. Lining of the cheek D. Maxillary sinus E. Posterior one-third of the tongue

B. Center of the lower lip

You were sent to examine a patient recovering from thyroidectomy surgery. Since the operation, the patient has been complaining of an inability to keep her right eye fully open. On examination, the patient presented an obvious ptosis (droopy eyelid) of the right side when relaxed and marked pupillary constriction in the right eye compared to the left. What structure had inadvertently been damaged by the surgeon? A. Ansa cervicalis B. Cervical sympathetic trunk C. Glossopharyngeal nerve D. Oculomotor nerve E. Recurrent (inferior) laryngeal nerve

B. Cervical sympathetic trunk

Which of the following conditions or actions results from stimulation of the parasympathetic fibers to the eyeball? A. Contraction of capillaries in the iris B. Contraction of the ciliary muscle C. Dilation of the pupil D. Enhanced vision for distant objects E. None of the above

B. Contraction of the ciliary muscle

During an automobile accident, the neck of an 82-year-old man was injured by the safety belt as the vehicle stopped suddenly. He complained of difficulty breathing and a sore "Adam's apple". The physician was examined him realized that it was necessary to perform an emergency cricothyrotomy to secure an adequate airway. What structure is incised to enter the airway during a cricothyrotomy? A. Cricoid cartilage B. Cricothyroid ligament C. Thyroid cartilage D. Thyrohyoid membrane E. Upper tracheal cartilage

B. Cricothyroid ligament

A young woman hit her head on the dashboard of her car during a head-on collision. The frontal area of her scalp was lacerated and bleeding profusely. The wound was cleansed with a saline solution and covered with a sterile bandage. By the time the woman reached the hospital, she had two black eyes. Further examination revealed that there was no injury to her eyes. The blood would pass to both eyes from the scalp in what layer of the scalp? A. Aponeurosis B. Cutaneous tissue or connective tissue (hypodermis) C. Loose connective tissue D. Periosteum (pericranium) E. Skin (epidermis and dermis)

B. Cutaneous tissue or connective tissue (hypodermis)

A 59-year-old woman was seen by her physician with a small swelling below her chin. On examination, a single hard swelling could be palpated in the submental triangle. It was mobile on the deep tissues and not tethered to the skin. A diagnosis of a malignant secondary deposit in a submental lymph node was considered. Where do the submental nodes drain? A. Anterior cervical nodes B. Deep cervical nodes C. Submandibular nodes D. Superficial cervical nodes E. Tracheobronchial nodes

B. Deep cervical nodes

What group of lymph nodes receives most of the lymph fluid from the extracranial (face, oral/nasal region) head and neck? A. Axillary nodes B. Deep cervical or internal jugular nodes C. Facial (buccal) nodes D. Parasternal nodes E. Superficial cervical or external jugular nodes

B. Deep cervical or internal jugular nodes

Which of the following conveys postganglionic neurons that course through the pterygoid canal and have their cell bodies located in the superior cervical ganglion? A. Chorda tympani nerve B. Deep petrosal nerve C. Greater petrosal nerve D. Lesser petrosal nerve E. Nasopalatine nerve

B. Deep petrosal nerve

Palsy of the right trochlear nerve may result in diplopia. In order to determine the nerve involved in the diplopia, what position of the eye movement would NOT occur? A. Down and out (lateral) movement B. Down and in (medial) movement C. Lateral movement D. Up and out (lateral) movement E. Up and in (medial) movement

B. Down and in (medial) movement

Which of the following statements regarding the "danger space" between the buccopharyngeal fascia and the prevertebral fascia is CORRECT? A. Connects the posterior triangle with the axilla B. Extends from the base of the skull into the mediastinum anterior to the vertebral column C. Is bounded by the superficial layer of deep cervical fascia D. Joins the superficial cervical fascia to form the carotid sheath E. Separates the thyroid gland from the trachea

B. Extends from the base of the skull into the mediastinum anterior to the vertebral column

Which of the following veins would be most visually prominent when venous pressure rises, as in heart failure, superior vena cava obstruction, enlarged supraclavicular lymph nodes, or increased intrathoracic pressure? A. Brachiocephalic veins B. External jugular veins C. Pterygoid plexus of veins D. Subclavian veins E. Superior, middle and inferior thyroid veins

B. External jugular veins

What nerve serves as the afferent (sensory) limb of the gag reflex? A. Facial nerve B. Glossopharyngeal nerve C. Hypoglossal nerve D. Trigeminal nerve E. Vagus nerve

B. Glossopharyngeal nerve

A patient is brought into the emergency department with an attack of paroxysmal tachycardia. The resident physician restores the heart to normal sinus rhythm by simple massage of the region superficial to the carotid sinus. What nerve primarily contains the afferent component of the cardiac reflex responsible for slowing the heart? A. Cardiac nerves arising from the cervical sympathetic chain B. Glossopharyngeal nerves C. Hypoglossal nerves D. Inferior roots of the ansa cervicalis E. Vagus nerves

B. Glossopharyngeal nerves

What nerve provides cutaneous sensation over the angle of the mandible? A. Auriculotemporal B. Great auricular C. Lesser occipital D. Supraclavicular E. Transverse cervical

B. Great auricular

What bony opening is located medial to the maxillary 2nd and 3rd molars? A. Incisive foramen B. Greater palatine foramen C. Mental foramen D. Pterygomaxillary fissure E. Sphenopalatine foramen

B. Greater palatine foramen

What cranial nerves can be evaluated, all or in part, if you are to do a thorough examination of the eye and its associated structures? A. II, III, IV, V, VI B. II, III, IV, V, VI, VII C. II, III, IV, V, VI, IX D. III, V, VI, VII E. III, IV, V, VII

B. II, III, IV, V, VI, VII

Lacrimal secretion enters the lateral aspect of the superior conjunctival fornix and ultimately drains via the lacrimal apparatus to what area? A. Inferior conjunctival fornix B. Inferior meatus of the nasal cavity C. Lacrimal sac D. Maxillary sinus E. Middle meatus of the nasal cavity

B. Inferior meatus of the nasal cavity

Which of the following is NOT a branch of the external carotid artery? A. Facial artery B. Inferior thyroid artery C. Lingual artery D. Maxillary artery E. Superior thyroid artery

B. Inferior thyroid artery

What part of the larynx is located between the vestibular folds and the vocal folds? A. Infraglottic cavity B. Laryngeal ventricle C. Laryngeal vestibule D. Piriform recess E. Rima glottidis

B. Laryngeal ventricle

A 45-year-old man was riding his bicycle when he swerved to avoid a pot hole and lost his balance. He crashed, hitting his head against a rock. When he regained consciousness in the emergency department of a neighboring hospital, it was immediately noted that he had medial strabismus (squint) of his right eye. Which eye muscle was paralyzed in this injury? A. Inferior rectus B. Lateral rectus C. Medial rectus D. Superior oblique E. Superior rectus

B. Lateral rectus

If the tongue deviates to the left upon protrusion, a lesion of which nerve has occurred? A. Left glossopharyngeal nerve B. Left hypoglossal nerve C. Right glossopharyngeal nerve D. Right hypoglossal nerve E. Right vagus nerve

B. Left hypoglossal nerve

On asking a patient to say "ah", the uvula is seen to be elevated upward and to the right. What cranial nerve is likely to be NOT functioning? A. Left glossopharyngeal nerve B. Left vagus nerve C. Right glossopharyngeal nerve D. Right hypoglossal nerve E. Right trigeminal nerve

B. Left vagus nerve

Which of the following conditions results from severance of the abducens nerve proximal to its entrance into the orbit? A. External strabismus (lateral deviation) B. Loss of abduction of the eye C. Loss of the pupil's ability to dilate D. Loss of visual accommodation E. Ptosis of the upper eyelid

B. Loss of abduction of the eye

Examination of the nasal cavity of a person with maxillary sinusitis might be expected to reveal a purulent (pus) discharge in what area? A. Inferior meatus B. Middle meatus C. Opening of the pharyngotympanic (eustachian) tube D. Sphenoethmoidal recess E. Superior meatus

B. Middle meatus

During batting practice, a ball was foul-tipped and struck the left side of the head of a player standing nearby. He fell to the ground and was unconscious for more than 3 minutes. The initial examination by the trainer revealed that the skin was not broken, but there was a swelling in the temporal fossa. The player complained of an intense headache, disorientation, and blurred vision. His left pupil was moderately dilated and reacted sluggishly to light. What nerve is injured to cause dilation of the eye? A. Abducens nerve B. Oculomotor nerve C. Optic nerve D. Trigeminal nerve E. Trochlear nerve

B. Oculomotor nerve

If a patient presented with a permanently dilated pupil, which one of the following nerves could be assumed to have a lesion? A. Facial nerve B. Oculomotor nerve C. Ophthalmic nerve D. Optic nerve E. Sympathetic trunk

B. Oculomotor nerve

Venous drainage from the face enters the internal jugular vein via the facial vein. To what other site may these veins drain? A. Cerebral veins B. Ophthalmic veins C. Sigmoid sinus D. Thyroid veins E. Vertebral venous plexus

B. Ophthalmic veins

The anterior scalene muscle is a readily found surgical landmark. What nerve crosses it anterior surface? A. Ansa cervicalis B. Phrenic nerve C. Sympathetic trunk D. Suprascapular nerve E. Vagus

B. Phrenic nerve

A 35-year-old female is brought to the emergency department where she is intubated with an endotracheal tube that is passed through an opening between the vocal folds. What is the name of the opening? A. Piriform recess B. Rima glottidis C. Vallecula D. Ventricle E. Vestibule

B. Rima glottidis

The inferior root (ramus) of the ansa cervicalis contains nerve fibers derived from which of the following? A. First and second cervical spinal nerves B. Second and third cervical spinal nerves C. Third and fourth cervical spinal nerves D. First, second, and third cervical spinal nerves E. Hypoglossal nerve

B. Second and third cervical spinal nerves

In a partial surgical resection of the thyroid gland, paralysis of the cricothyroid muscle occurred. What possibly produced the paralysis? A. Severing of the inferior (recurrent) laryngeal nerve B. Severing of the external branch of the superior laryngeal nerve C. Severing of the vagus nerve in the carotid sheath D. Secondary infection following surgery E. Trauma to the muscle during surgery

B. Severing of the external branch of the superior laryngeal nerve

A shortstop fielding a ground ball was hit on the side of the nose when the ball bounced unexpectedly. The nose was deformed and the nasal bones displaced. Disruption of the nasal cartilages was also detected. Epistaxis (nosebleed) was present, blood was spurting from his nose, and his nasal airway was obstructed. What vessels are usually responsible for blood spurting from the nose? A. Middle meningeal and ophthalmic arteries B. Sphenopalatine, ethmoidal, and labial arteries C. Superficial temporal, ophthalmic, and middle meningeal arteries D. Supraorbital, infraorbital and mental arteries E. Transverse facial and ophthalmic arteries

B. Sphenopalatine, ethmoidal, and labial arteries

What portions of the cervical vertebrae can usually be palpated on a normal living person? A. Spinous process of C7 and transverse process of C2 B. Spinous process of C6 and C7, and no transverse processes C. Spinous process of C2 through C7, and no transverse processes D. Spinous process of C6 and C7, and transverse processes of C2 and C7 E. None of the above

B. Spinous process of C6 and C7, and no transverse processes

Removal of which muscle would expose most of the chain of deep cervical lymph nodes? A. Omohyoid B. Sternocleidomastoid C. Sternohyoid D. Sternothyroid E. Trapezius

B. Sternocleidomastoid

Regarding the orbit, which of the following is INCORRECT? A. Bones contributing to it include the palatine and sphenoid. B. The very thin lamina papyracea is all that separates orbit from maxillary sinus* C. A large majority of orbital infections (orbital cellulitis) originate within adjacent paranasal sinuses. D. Important postganglionic parasympathetic nerve fibers from the pterygopalatine ganglion ascend from the zygomatic nerve to the lacrimal nerve along its lateral wall. E. The bulbus oculi lies in the anterior one-half of the bony orbit.

B. The very thin lamina papyracea is all that separates orbit from maxillary sinus*

What is responsible for closure of the nasal cavity from the oropharynx during swallowing? A. Bending of the epiglottis B. Contraction of the aryepiglottic muscles C. Contraction of the tensor and levator veli palatine muscles D. Elevation of the tongue to the roof of the mouth E. Relaxation of the pharyngeal constrictor muscles

C. Contraction of the tensor and levator veli palatine muscles

Which of the following nerves innervates a muscle that elevates the pharynx? A. External branch of the superior laryngeal B. Facial C. Glossopharyngeal D. Inferior or recurrent laryngeal E. Internal branch of the superior laryngeal

C. Glossopharyngeal

A 58-year-old man with deceased tear production is diagnosed with a tumor at the base of the skull following a MRI scan of the head. Which of the following nerves is most likely involved in this lesion? A. Chorda tympani B. Deep petrosal C. Greater petrosal D. Lesser petrosal E. Nasociliary

C. Greater petrosal

Which branch of the facial nerve conveys preganglionic parasympathetic fibers to the lacrimal gland A. Chorda tympani B. Deep petrosal nerve C. Greater petrosal nerve D. Lacrimal nerve E. Lesser petrosal nerve

C. Greater petrosal nerve

Pupillary constriction, ptosis of the eyelid, anhidrosis (absence of sweating), and flushing of the face are characteristics of what clinical condition? A. Bell's palsy B. Facial nerve paralysis C. Horner's syndrome D. Interruption of the oculomotor nerve E. Optic nerve degeneration

C. Horner's syndrome

A 27-year-old medical student consulted her clinical instructor about a painless, plum-shaped swelling in the anterior triangle of her neck, inferior to the angle of her mandible. As her mandibular 3rd molar teeth (wisdom teeth) had not erupted, she thought the swelling might be caused by a dental abscess in the submandibular triangle because her 3rd molar on that side was producing some pain. She also feared that the swelling might be caused by a tumor of her submandibular gland or be an enlargement of the jugulodigastric lymph node. A lateral cervical cyst was diagnosed? What nerve might be damaged when removing the cyst and any sinus tract? A. Facial nerve B. Glossopharyngeal nerve C. Hypoglossal nerve D. Spinal accessory nerve E. Vagus nerve

C. Hypoglossal nerve

Which of the following structures pierces the thyrohyoid membrane? A. External branch of the superior laryngeal nerve and superior laryngeal artery B. Hypoglossal nerve and lingual artery C. Internal branch of the superior laryngal nerve and superior laryngeal artery D. Recurrent laryngeal nerve and inferior thyroid artery E. Vagus nerve and superior thyroid artery

C. Internal branch of the superior laryngal nerve and superior laryngeal artery

A fish bone lodged in the piriform fossa of the laryngopharynx would provide strong stimulation of nerve endings associated with which of the following nerves? A. External branch of the superior laryngeal nerve B. Glossopharyngeal nerve C. Internal branch of the superior laryngeal nerve D. Phrenic nerve E. Recurrent (inferior) laryngeal nerve

C. Internal branch of the superior laryngeal nerve

Which of the following statements regarding the cervical portion of the sympathetic trunk and its ganglia is INCORRECT? A. It extends to the base of the skull. B. It connects to all cervical spinal nerves via gray rami. C. It connects to all cervical spinal nerves via white rami. D. It contributes postganglionic branches to the pharyngeal plexus of nerves. E. Postganglionic fibers leave it and follow blood vessels to structures of the head and neck.

C. It connects to all cervical spinal nerves via white rami.

The thoracic duct normally drains into the angle of the junction of what two veins? A. Left external jugular and left retromandibular B. Left internal jugular and left facial C. Left internal jugular and left subclavian D. Right facial and right retromandibular E. Right internal jugular and right subclavian

C. Left internal jugular and left subclavian

Which nerve contains most of the sensory fibers from the cornea of the eyeball? A. Frontal nerve B. Lacrimal nerve C. Long ciliary nerve D. Short ciliary nerve E. Oculomotor nerve

C. Long ciliary nerve

A 26-year-old man was seen in the emergency department after being hit in the eye with a pool cue during a brawl. Examination of the eye showed no serious injury except for bleeding into the anterior chamber. The physician was concerned about the condition of the eye and referred the patient to an ophthalmologist. The ophthalmologist diagnosed a "blowout" fracture involving which sinus? A. Cavernous sinus B. Frontal sinus C. Maxillary sinus D. Sphenoparietal sinus E. Sphenoidal sinus

C. Maxillary sinus

A young woman who was recovering from a severe cold and a "stuffed-up" nose complained to her physician about pain in her upper jaw. She said she had been to her dentist but he told her that her teeth were not infected. What structure in her upper jaw could cause pain in her cheek? A. Ethmoidal sinus B. Frontal sinus C. Maxillary sinus D. Sphenoidal sinus E. Temporomandibular joint

C. Maxillary sinus

During a physical examination of a patient with severe facial ache, a family physician noted drainage of purulent discharge into the left middle meatus when the patient was lying on the right side. What is the most likely source of the infection? A. Anterior ethmoidal sinuses B. Frontal sinus C. Maxillary sinus D. Nasolacrimal duct E. Sphenoid sinus

C. Maxillary sinus

Into what area would a "blow-out" fracture involving the orbital floor displace some of the contents of the orbit? A. Ethmoidal sinus B. Frontal sinus C. Maxillary sinus D. Oral cavity E. Sphenoid sinus

C. Maxillary sinus

Although the ciliary action of the mucosa facilitates drainage of the paranasal sinuses, body position is paramount. Which of the following paranasal sinuses does NOT drain by gravity with the body in the erect position? A. Anterior ethmoidal sinuses B. Frontal sinuses C. Maxillary sinuses D. Middle ethmoidal sinuses E. Posterior ethmoidal sinuses

C. Maxillary sinuses

A 60-year-old male visits his family physician because of pain in his left-sided maxillary teeth. Tapping on his left maxilla during the physical examination elicited sharp pain on the left side of his face. Which of the following conditions will be the most likely diagnosis? A. Anterior ethmoidal sinusitis B. Frontal sinusitis C. Maxillary sinusitis D. Posterior ethmoidal sinusitis E. Sphenoid sinusitis

C. Maxillary sinusitis

An unconscious 52-year-old woman is admitted to the hospital after a CT scan reveals a tumor in her cranial cavity. After she regained consciousness, physical examination revealed that her right eye was directed laterally and downward; with complete ptosis of her upper eyelid, and a dilated pupil. Which of the following structures was most likely affected by the tumor to produce these symptoms? A. Ciliary ganglion B. Facial nerve C. Oculomotor nerve D. Superior cervical ganglion E. Trochlear nerve

C. Oculomotor nerve

A 16-year-old youth was referred to a dermatologist for treatment of a severe case of acne (acne vulgaris). The physician observed an abscess (boil) on the ala of the youth's nose that had developed a yellow "head" at its apex. She treated the youth with antibiotics but warned him not to pick or squeeze the boil because it might cause the infection to spread to the meninges (meningitis) and brain (encephalitis). Through which vessels could infection spread from the nose to the cavernous sinus and brain? A. External jugular veins B. Inferior labial veins C. Ophthalmic veins D. Pterygoid venous plexus E. Superficial temporal veins

C. Ophthalmic veins

What veins may enable an infection of the upper lip to spread to the meninges of the brain? A. Internal jugular veins B. Mastoid emissary veins C. Ophthalmic veins D. Retromandibular veins E. Vertebral venous plexus

C. Ophthalmic veins

What structures or area is located between the palatoglossal and palatopharyngeal folds? A. Adenoids B. Epiglottis C. Palatine tonsil D. Piriform recess E. Valleculae

C. Palatine tonsil

The palatine tonsil lies between which of the following pairs of muscles? A. Palatoglossus and styloglossus B. Palatoglossus and stylopharyngeus C. Palatopharyngeus and palatoglossus D. Stylopharyngeus and styloglossus E. Superior pharyngeal constrictor and stylopharyngeus

C. Palatopharyngeus and palatoglossus

What structure is removed with an adenoidectomy? A. Lingual tonsils B. Palatine tonsils C. Pharyngeal tonsils D. Tongue E. Uvula

C. Pharyngeal tonsils

Which of the following branches of the cervical plexus does NOT contain cutaneous fibers? A. Greater auricular nerve B. Lesser occipital nerve C. Phrenic nerve D. Supraclavicular nerve E. Transverse cervical nerve

C. Phrenic nerve

Which of the following nerves does NOT enter the posterior triangle of the neck deep to the posterior border of the sternocleidomastoid muscle? A. Great auricular nerve B. Lesser occipital nerve C. Phrenic nerve D. Supraclaviculars E. Transverse cervical

C. Phrenic nerve

What muscle opens the rima glottidis? A. Cricothyroid B. Lateral cricoarytenoid C. Posterior cricoarytenoid D. Thyroarytenoid E. Transverse arytenoid

C. Posterior cricoarytenoid

Which of the following muscles is an abductor of the vocal cords? A. Cricothyroid B. Lateral cricoarytenoid C. Posterior cricoarytenoid D. Thyroarytenoid E. Transverse arytenoid

C. Posterior cricoarytenoid

A person is attacked with a baseball bat and sustains a cranial fracture that extends through the jugular foramen and injures the enclosed nerves. The patient is hoarse and complains of having difficulty swallowing. Hoarseness is due to paralysis of the laryngeal muscles and abnormal positioning of the vocal fold on the involved side. Which of the following muscles normally abducts the vocal folds? A. Cricothyroid muscle B. Lateral cricoarytenoid muscle C. Posterior cricoarytenoid muscle D. Thyroarytenoid muscle E. Transverse arytenoid muscle

C. Posterior cricoarytenoid muscle

A 30-year-old woman was concerned about a swelling in the anterior part of her neck, nervousness, and loss of weight. She told her family physician that her family complains that she is irritable, excitable, and cries easily. A swelling was detected on each side of her neck inferior to the larynx. During palpation of the patient's neck from a posterior position, the physician felt an enlarged thyroid gland and noted that it moved up and down during swallowing. The following signs were also detected: protrusion of the eyes, rapid pulse, tremor of the digits, moist palms, and loss of weight. What nerve was probably responsible for the patient's hoarseness? A. Glossopharyngeal nerve B. Hypoglossal nerve C. Recurrent (inferior) laryngeal nerve D. Superior laryngeal nerve E. Vagus nerve

C. Recurrent (inferior) laryngeal nerve

During operations on the thyroid gland, which of the following nerves may be injured when tying the inferior thyroid artery? A. Descendens cervicalis B. Internal laryngeal nerve C. Recurrent laryngeal nerve D. Superior laryngeal nerve E. Sympathetic trunk

C. Recurrent laryngeal nerve

With which nerve does the inferior thyroid artery have a very close and important clinical relationship? A. Hypoglossal nerve B. Phrenic nerve C. Recurrent laryngeal nerve D. Superior laryngeal nerve E. Vagus nerve

C. Recurrent laryngeal nerve

An elderly man was taken to the E.D. because he had an object lodged in his throat. A small steak bone was removed by esophagoscopy and a small posterior tear of the esophagus is observed. The patient is placed on antibiotic therapy to prevent infection from developing in what area? A. Carotid sheath B. Piriform fossa C. Retropharyngeal space D. Tonsillar bed E. Vertebral canal

C. Retropharyngeal space

Which of the following statements concerning the pharynx is INCORRECT? A. The anterior wall of the nasal part of the pharynx is formed by the posterior nasal apertures (choanae). B. The lowest fibers of the inferior constrictor muscle serve as an esophageal sphincter at the lower end of the pharynx. C. Sensory nerve ending in the mucous membrane of the oral part of the pharynx are mainly from the internal laryngeal nerve. D. The piriform fossa is situated on each side of the laryngeal inlet into the pharynx. E. All the constrictors of the pharynx are innervated by the pharyngeal plexus.

C. Sensory nerve ending in the mucous membrane of the oral part of the pharynx are mainly from the internal laryngeal nerve.

A person is attacked with a baseball bat and sustains a cranial fracture that extends through the jugular foramen and injures the enclosed nerves. The patient is hoarse and complains of having difficulty swallowing. When the interior of the mouth is examined and the patient asked to say "ah", the palate is observed to deviate to the normal side and there is loss of the gag reflex on the injured side. Which of the following muscles in NOT paralyzed? A. Levator veli palatini B. Palatopharyngeus C. Stylohyoid D. Stylopharyngeus E. Superior pharyngeal constrictor

C. Stylohyoid

A person is attacked with a baseball bat and sustains a cranial fracture that extends through the right jugular foramen and injures the enclosed nerves. The patient is hoarse and complains of having difficulty swallowing. When the interior of the mouth is examined and the patient asked to say "ah", the palate is observed to deviate to the left side and there is loss of the gag reflex on the injured side. Which of the following muscles in NOT paralyzed? A. Levator veli palatini B. Palatopharyngeus C. Stylohyoid D. Stylopharyngeus E. Superior pharyngeal constrictor

C. Stylohyoid

What structure covers (invests) the muscles forming the floor of the posterior triangle of the neck? A. Prevertebral deep fascia B. Superficial fascia C. Superficial layer of deep cervical fascia D. Platysma E. None of the above

C. Superficial layer of deep cervical fascia

What structure lies parallel and immediately deep to the carotid sheath in the neck? A. Internal jugular vein B. Superior ramus of the ansa cervicalis C. Sympathetic trunk D. Trachea E. Vagus nerve

C. Sympathetic trunk

Upon inspecting the oral cavity of an unsuspecting and probably gullible patient, you notice a slight swelling between folds created by the palatoglossus and palatopharyngeus muscles on the right side. You ask the patient to turn his head and cough three times while you try to think of a reason for the swelling. What is likely to be responsible for the swelling? A. An infected submandibular gland B. Prolapsed adenoids C. The palatine tonsil D. The torus tubarius E. The uncinate process

C. The palatine tonsil

Which of the following statements below concerning nerves of the neck is INCORRECT? A. Cutaneous nerves of the neck are branches of the cervical plexus. B. The transverse cervical nerve provides sensory innervation to the anterior and lateral parts of the neck. C. The supraclavicular nerves innervate the platysma muscle. D. The motor nerves for most infrahyoid muscles are branches of the ansa cervicalis. E. Anterior primary rami of the second, third, and fourth cervical nerves contribute to the cervical plexus.

C. The supraclavicular nerves innervate the platysma muscle.

While hiking, a sharp twig snapped back and punctured the skin of your neck. The wound was shown to pass through the platysma muscle but not to enter the underlying sternocleidomastoid muscle or its fascial investments. Which of the following statements is CORRECT? A. The wound involves mainly the superficial layer of deep cervical fascia. B. The wound is confined to the retrovisceral space. C. The wound is confined to the skin and the superficial cervical fascia. D. The wound disrupted the carotid sheath. E. The wound injured the accessory nerve.

C. The wound is confined to the skin and the superficial cervical fascia.

A 65-year-old woman consulted her physician about muscle weakness, anorexia, nausea, constipation, and polyuria (passage of large volumes of urine). After taking a thorough history and performing an extensive physical examination, the physician ordered laboratory studies of her blood and urine. The laboratory reports revealed an elevated serum calcium concentration, an elevated serum level of parathyroid hormone, and an elevated urinary calcium excretion. A diagnosis of parathyroid adenoma was made. It was decided that resection of the enlarged gland(s) should be carried out. The surgeon located the superior parathyroid glands without difficulty and found them to be normal in size. She could locate only one inferior parathyroid gland. Because it was enlarged and a frozen section suggested parathyroid hyperplasia and parathyroid adenoma, the gland was removed. She systematically searched the anterior part of the neck for the fourth parathyroid gland, but was unable to find it. Continued searching resulted in detection of the gland. Where do you think the surgeon may have found the ectopic parathyroid gland? A. Lung B. Pericardial sac C. Thymus D. Thyroid gland E. Tongue

C. Thymus

A 6-year-old boy was taken to a family physician for treatment of a persistent sore throat. During the physical examination the physician observed infection and hypertrophy of the tonsils and adenoids. He also detected an enlarged tonsillar lymph node. Although the boy's tonsils were the site of chronic infection, he was reluctant to recommend a tonsillectomy and adenoidectomy. Because of the vascularity of the palatine tonsils, tonsillectomy can be dangerous. Which artery may bleed after tonsillectomy? A. Ascending cervical artery B. Maxillary artery C. Superficial temporal artery D Tonsillar branch of the facial artery E. Transverse facial artery

D Tonsillar branch of the facial artery

What cranial nerve is responsible for pain sensation from the cornea? A. CN II B. CN III C. CN IV D. CN V E. CN VI

D. CN V

Where is the isthmus of the thyroid gland palpable during physical examination of the thyroid gland? A. Above the body of the hyoid bone B. Between the hyoid bone and thyroid cartilage C. Between the thyroid cartilage and cricoid cartilage D. Inferior to the cricoid cartilage and over the upper two or three tracheal cartilages* E. Lying against the lateral lamina of the thyroid cartilage

D. Inferior to the cricoid cartilage and over the upper two or three tracheal cartilages*

Which of the following statements concerning the internal laryngeal nerve is INCORRECT? A. It is a branch of the superior laryngeal nerve. B. It pierces the thyrohyoid membrane. C. It is sensory to the mucosa of the larynx. D. It is motor to the cricothyroid muscle. E. It is accompanied by the superior laryngeal artery.

D. It is motor to the cricothyroid muscle.

Which of the following statements concerning the carotid sinus is CORRECT? A. It is located at the origin of the external carotid artery. B. It is innervated by the facial nerve. C. It functions as a chemoreceptor. D. It is stimulated by changes in blood pressure. E. It drains blood from the dural venous sinuses.

D. It is stimulated by changes in blood pressure.

A 27-year-old woman is examined in the E.D. because of severe head injuries after a car crash. The neurologic examination revealed that her uvula was deviated to the right. Which nerve is most likely affected to result in this deviation? A. Left glossopharyngeal B. Right glossopharyngeal C. Right hypoglossal D. Left vagus E. Right vagus

D. Left vagus

What nerve provides general sensation to the anterior two-thirds of the tongue? A. Facial B. Glossopharyngeal C. Hypoglossal D. Lingual E. Vagus

D. Lingual

What nerve is responsible for the afferent limb of the sneeze reflex? A. Facial nerve (CN VII) B. Glossopharyngeal nerve (CN IX) C. Mandibular nerve (CN V3) D. Maxillary nerve (CN V2) E. Vagus (CN X)

D. Maxillary nerve (CN V2)

After entering the submandibular triangle, the lingual artery passes immediately deep to which of the following muscles? A. Anterior belly of the digastric B. Genioglossus C. Hypoglossus D. Mylohyoid E. Styloglossus

D. Mylohyoid

Infection may spread from the nasal cavity to the meninges along the olfactory nerves. Through what structures do olfactory nerve fibers pass from the mucosa of the nasal cavity to the olfactory bulb? A. Anterior and posterior ethmoidal foramina B. Hiatus semilunaris C. Nasociliary nerves D. Olfactory foramina of the cribriform plate E. Sphenopalatine foramen

D. Olfactory foramina of the cribriform plate

Which of the following structures does NOT pass through the superior orbital fissure? A. Abducens nerve B. Frontal nerve C. Ophthalmic veins D. Optic nerve E. Trochlear nerve

D. Optic nerve

A complete anteroposterior cleft of the hard palate would involve which bones? A. Ethmoid and frontal bones B. Maxillary and frontal bones C. Palatine and ethmoid bones D. Palatine and maxillary bones E. Sphenoid and zygomatic bones

D. Palatine and maxillary bones

An elderly man has difficulty manipulating food within the oral cavity before swallowing. Physical examination reveals his tongue deviates to the left on protrusion. A CT scan demonstrates an extramedullary mass in the vicinity of the hypoglossal canal (foramen). Which of the following muscles remains functional with paralysis of the hypoglossal nerve? A. Genioglossus B. Hyoglossus C. Intrinsic vertical and transverse tongue muscles D. Palatoglossus E. Styloglossus

D. Palatoglossus

An 8-year-old boy is brought to his family physician with a high fever and pain in his ear. Physical examination revealed that both his throat and tympanic membrane were red and inflamed. Which of the following provided a pathway for the spread of infection between the two structures? A. Choanae B. External acoustic meatus C. Internal acoustic meatus D. Pharyngotympanic tube E. Tympanic recess

D. Pharyngotympanic tube

Which of the following is NOT an adductor of the vocal cords? A. Arytenoideus muscles B. Cricothyroid muscles C. Lateral cricoarytenoid muscles D. Posterior cricoarytenoid muscles

D. Posterior cricoarytenoid muscles

The carotid nerve (periarterial nerve plexus) is composed of what type of nerve fibers? A. Afferent branches of the vagus nerve B. Cervical nerves 1-6 C. Efferent branches of the vagus nerve D. Postganglionic sympathetic nerve fibers E. Preganglionic sympathetic nerve fibers

D. Postganglionic sympathetic nerve fibers

A 34-year-old woman who underwent a thyroidectomy, postoperatively presented with hoarseness. Which of the following nerves was most likely traumatized during the operation? A. External laryngeal nerve B. Glossopharyngeal nerve C. Internal laryngeal nerve D. Recurrent laryngeal nerve E. Superior laryngeal nerve

D. Recurrent laryngeal nerve

A tonsillar abscess may extend posteriorly through the posterior pharyngeal wall into what area? A. Anterior triangle of the neck B. Pharyngeal tonsil C. Pleural cavity D. Retropharyngeal space E. Suprasternal space

D. Retropharyngeal space

A 22-year-old man is brought to the emergency department because of a suprahyoid stab wound that extends from one side of the neck to the other. His tongue deviates to the right when protruded; there is no loss of sensory modality on the tongue. The injury most likely involves which of the following nerves? A. Left hypoglossal B. Left vagus C. Right glossopharyngeal D. Right hypoglossal E. Right lingual

D. Right hypoglossal

Which of the following bones does NOT contribute to the bony nasal septum? A. Ethmoid B. Maxillary C. Palatine D. Sphenoid E. Vomer

D. Sphenoid

What structure is used to divide the lateral aspect of the neck into anterior and posterior triangles? A. Common carotid artery B. External jugular vein C. Spinal accessary nerve D. Sternocleidomastoid muscle E. Stylohyoid muscle

D. Sternocleidomastoid muscle

Which of the hyoid muscles is NOT supplied by ventral primary rami of one or more of the first three cervical spinal nerves? A. Geniohyoid B. Omohyoid C. Sternohyoid D. Stylohyoid E. Thyrohyoid

D. Stylohyoid

Which of the following structures is found anterior to the anterior scalene muscle? A. Anterior ramus of the seventh cervical nerve B. Roots of the brachial plexus C. Subclavian artery D. Subclavian vein E. Suprapleural membrane

D. Subclavian vein

A 20-year-old man with moderate fever and a sore throat noticed a swelling on the right side of his face anterior to his ear. He was also concerned when another swelling appeared below his jaw. He quickly arranged an appointment with his family physician. During the physical examination the physician observed enlargement of the right parotid and submandibular glands. Palpation of the parotid gland was painful. Examination of the oral cavity revealed redness of the openings of the ducts of these glands. The pain of the swollen parotid gland increased when he was asked to sip lemon juice. A diagnosis of mumps was made. In which triangle of the neck is the submandibular gland located? A. Carotid triangle B. Muscular triangle C. Occipital triangle D. Submandibular triangle E. Submental triangle

D. Submandibular triangle

Which regional lymph nodes usually receive lymph directly from the middle third of the lower lip? A. Inferior deep cervical B. Pretracheal C. Submandibular D. Submental E. Superior deep cervical

D. Submental

A 27-year-old female is brought to the emergency department following an automobile accident. Physical examination revealed a right pupillary miosis and anhydrosis of the right face. A CT scan of the head and neck revealed a large hematoma inferior to the right jugular foramen. Which of the following ganglia is most likely affected by the hematoma? A. Ciliary ganglion B. Geniculate ganglion C. Pterygopalatine ganglion D. Superior cervical ganglion E. Trigeminal ganglion

D. Superior cervical ganglion

A 52-year-old man presents with a constricted right pupil that does not react to light. His left pupil and vision in both eyes are normal. Which of the following structures on the right side are most likely involved in this lesion? A. Ciliary ganglion B. Nucleus of Edinger-Westphal C. Optic nerve D. Superior cervical ganglion E. Trigeminal ganglion

D. Superior cervical ganglion

Where are cell bodies of neurons responsible for pupillary dilation located? A. Ciliary ganglion B. Otic ganglion C. Pterygopalatine ganglion D. Superior cervical ganglion of the sympathetic trunk E. Trigeminal ganglion

D. Superior cervical ganglion of the sympathetic trunk

A 6-year-old boy was taken to a family physician for treatment of a persistent sore throat. During the physical examination, the physician observed infection and hypertrophy of the tonsils and adenoids. He also detected an enlarged tonsillar lymph node. Although the boy's tonsils were the site of chronic infection, he was reluctant to recommend a tonsillectomy and adenoidectomy. Which lymph node is commonly referred to as the tonsillar lymph node? A. Inferior deep cervical node B. Submandibular node C. Submental node D. Superior deep cervical node E. Supraclavicular node

D. Superior deep cervical node

What muscle attaches posteriorly to the pterygomandibular ligament (raphe)? A. Levator palatini B. Middle pharyngeal constrictor C. Palatopharyngeus D. Superior pharyngeal constrictor E. Tensor veli palatini

D. Superior pharyngeal constrictor

Which of the following arteries is usually the first branch of the external carotid artery? A. Facial artery B. Inferior thyroid artery C. Lingual artery D. Superior thyroid artery E. Thyroid ima artery

D. Superior thyroid artery

Which of the following statements concerning accommodation of the eye is CORRECT? A. Accommodation for objects close to the eye is mediated by sympathetic nerve action. B. During accommodation for objects close to the eye, the lens becomes thinner. C. During accommodation, the lens does not change shape; it moves forward to backward. D. The ciliary muscle contracts when its parasympathetic fibers are stimulated. E. The ciliary muscle contracts to make the lens thinner.

D. The ciliary muscle contracts when its parasympathetic fibers are stimulated.

Which of the following nerves supply sensory fibers to the mucosa of the piriform recess? A. External branch of the superior laryngeal B. Facial C. Glossopharyngeal D. Inferior or recurrent laryngeal E. Internal branch of the superior laryngeal

E. Internal branch of the superior laryngeal

Which sensory nerve enters the larynx by passing through the thyrohyoid membrane? A. External branch of the superior laryngeal B. Glossopharyngeal C. Hypoglossal D. Inferior (recurrent) laryngeal E. Internal branch of the superior laryngeal

E. Internal branch of the superior laryngeal

Which of the following statements regarding the recurrent laryngeal nerve is INCORRECT? A. It innervates the laryngeal mucosa below the vocal cords. B. It is a branch of the vagus nerve. C. It is located in the tracheoesophageal groove. D. It is located deep to and in close relation to the thyroid gland. E. It loops around the subclavian artery on the left.

E. It loops around the subclavian artery on the left.

Which of the following statements concerning the superior cervical ganglion is INCORRECT? A. It is the most superior ganglion of the sympathetic trunk. B. It contains cell bodies of postganglionic sympathetic neurons. C. It is an autonomic ganglion. D. It receives preganglionic axons from the intermediolateral (lateral) horn of the spinal cord. E. It receives white rami communicantes from C1-C3.

E. It receives white rami communicantes from C1-C3.

Which of the following statements concerning the larynx is INCORRECT? A. It acts as a protective sphincter separating the respiratory tract from the digestive tract. B. It is involved in voice production (phonation). C. It plays a role in developing increased intra-abdominal pressure during childbirth. D. It opens the vocal folds by the action of the posterior cricoarytenoid muscles. E. It's mucosa is innervated by sensory afferent fibers from the glossopharyngeal nerve.

E. It's mucosa is innervated by sensory afferent fibers from the glossopharyngeal nerve.

Which of the following does NOT drain into the middle meatus of the nasal cavity? A. Anterior ethmoidal sinuses B. Frontal sinus C. Maxillary sinus D. Middle ethmoidal sinuses E. Nasolacrimal duct

E. Nasolacrimal duct

Which of the following nerves supplies sensory fibers to the anterior one-third of the hard palate? A. Chorda tympani B. Deep petrosal C. Greater petrosal D. Lesser petrosal E. Nasopalatine

E. Nasopalatine

Which of the following structures is found within the inferior meatus of the nasal cavity? A. Ethmoidal bulla B. Hiatus semilunaris C. Opening of the frontonasal duct D. Opening of the maxillary sinus E. Opening of the nasolacrimal duct

E. Opening of the nasolacrimal duct

A 72-year-old woman who is unconscious is brought to the emergency room after falling and hitting her head. The pupillary light reflex was abnormal. The integrity of which of the following nerves is checked when doing the pupillary light reflex? A. Maxillary and facial B. Ophthalmic and facial C. Ophthalmic and oculomotor D. Optic and facial E. Optic and oculomotor

E. Optic and oculomotor

Which of the following statements concerning the orbicularis oculi muscle is INCORRECT? A. It is supplied by temporal and zygomatic branches of the facial nerve. B. Its function is to close the eyelids. C. It is branchiomeric in origin. D. Paralysis results in spilling of tears. E. Ptosis of the eye occurs with paralysis.

E. Ptosis of the eye occurs with paralysis.

A patient is suspected of having a basal skull fracture. During examination of the oropharynx, she is asked to stick out her tongue and say "ah". Indirect laryngoscopy is then performed by inserting a mirror into the oropharynx. Adduction of the true vocal fold on the right side results from injury to which nerve? A. Left glossopharyngeal nerve B. Left lingual nerve C. Right glossopharyngeal nerve D. Right hypoglossal nerve E. Right vagus nerve

E. Right vagus nerve

Which of the following structures does NOT empty or open into the middle nasal meatus? A. Anterior ethmoidal air cells B. Frontal sinus C. Maxillary sinus D. Middle ethmoidal air cells E. Sphenoid sinus

E. Sphenoid sinus

Which of the following muscles is NOT innervated by the vagus nerve? A. Levator veli palatini B. Palatoglossus C. Palatopharyngeus D. Pharyngeal constrictors E. Stylopharyngeus

E. Stylopharyngeus

Which of the following describes the boundaries of the carotid triangle? A. Inferior belly of the omohyoid, the sternohyoid, and the anterior border of the sternomastoid B. Inferior belly of the omohyoid, the stylohyoid, and the anterior border of the sternomastoid C. Superior belly of the omohyoid, the anterior belly of the digastric, and the anterior border of the sternomastoid D. Superior belly of the omohyoid, the inferior belly of the omohyoid, and the anterior border of the sternomastoid E. Superior belly of the omohyoid, the posterior belly of the digastric, and the anterior border of the sternomastoid

E. Superior belly of the omohyoid, the posterior belly of the digastric, and the anterior border of the sternomastoid

Where do the sympathetic preganglionic nerve fibers synapse that are destined to supply the arteries of the head? A. Ciliary ganglion B. Inferior cervical chain ganglion C. Pterygopalatine ganglion D. Submandibular ganglion E. Superior cervical chain ganglion

E. Superior cervical chain ganglion

1. Where are the cell bodies of the neurons responsible for pupillary dilation located? A. Ciliary body B. Ciliary ganglion C. Nucleus of Edinger-Westphal D. Pterygopalatine ganglion E. Superior cervical ganglion

E. Superior cervical ganglion

A 56-year-old male patient complains of diplopia. On neurologic examination he is unable to adduct his left eye and lacks a corneal reflex in the left side. Where is the most likely location of the lesion resulting in the clinical signs? A. Foramen ovale B. Foramen rotundum C. Inferior orbital fissure D. Optic canal E. Superior orbital fissure

E. Superior orbital fissure

Having an individual abduct and elevate the eye provides a test of the strength of the lateral rectus muscle and what additional muscle? A. Inferior oblique B. Inferior rectus C. Levator palpebrae superioris D. Superior oblique E. Superior rectus

E. Superior rectus

Where are cell bodies of parasympathetic preganglionic neurons to the glands of the hard palate located? A. Geniculate ganglion B. Otic ganglion C. Pterygopalatine ganglion D. Submandibular ganglion E. Superior salivatory nucleus

E. Superior salivatory nucleus

In drinking while bending over a water fountain, nasal regurgitation of water is prevented by the contraction of a muscle innervated by the mandibular division of the trigeminal nerve (CN V3). Which of the following muscles is involved? A. Levator veli palatini B. Palatopharyngeus C. Stylopharyngeus D. Superior constrictor of pharynx E. Tensor veli palatini

E. Tensor veli palatini

Which of the muscles of the soft palate is NOT innervated by the vagus nerve? A. Levator veli palatini B. Musculus uvulae C. Palatoglossus D. Palatopharyngeus E. Tensor veli palatini

E. Tensor veli palatini

Which of the following statements concerning the tongue is INCORRECT? A. It contains intrinsic and extrinsic muscles. B. It contains lymphoid tissue. C. It receives nerve fibers from cranial nerves V, VII, IX, X and XII. D. It receives blood from a branch of the external carotid artery. E. The palatoglossus muscle is innervated by the hypoglossal nerve.

E. The palatoglossus muscle is innervated by the hypoglossal nerve.

Which of the following nerves is derived from the ventral rami of the second and third cervical spinal nerves? A. Auriculotemporal B. Buccal nerve C. Cervical branch of CN VII D. Infraorbital nerve E. Transverse cervical

E. Transverse cervical

A young man was slashed deeply with a knife in the middle of the right posterior triangle of the neck. The cut ended anterior to the middle of the sternocleidomastoid muscle. The bleeding was arrested and the wound was sutured. The patient, who was right-handed, later complained that he had difficulty combing his hair and tilting his head to the right. What artery was most likely responsible for the bleeding? A. External carotid artery B. Internal carotid artery C. Occipital artery D. Superficial temporal artery E. Transverse cervical artery

E. Transverse cervical artery

At what level does the common carotid artery bifurcate? A. Hyoid bone B. Lower border of the cricoid cartilage C. Sternal notch D. Thyroid gland isthmus E. Upper border of the thyroid cartilage

E. Upper border of the thyroid cartilage

The afferent limb of the cough reflex involves which cranial nerve? A. Facial nerve B. Glossopharyngeal nerve C. Hypoglossal nerve D. Mandibular division of the trigeminal nerve E. Vagus nerve

E. Vagus nerve

Which of the following nerves provides motor innervation to the intrinsic muscles of the larynx? A. Chorda tympani nerve B. Glossopharyngeal nerve C. Hypoglossal nerve D. Lingual nerve E. Vagus nerve

E. Vagus nerve

A patient is brought into the emergency department with an attack of paroxysmal tachycardia. The attending physician restores the heart to normal sinus rhythm by simple massage of the region superficial to the carotid sinus. What nerve constitutes the efferent component of the cardiac reflex that slows the heart? A. Cardiac nerves arising from the cervical sympathetic chain B. Glossopharyngeal nerves C. Hypoglossal nerves D. Inferior roots of the ansa cervicalis E. Vagus nerves

E. Vagus nerves

A 65-year-old woman visits the walk-in clinic because she believes there is something wrong when she speaks. Physical examination revealed she had difficulty coughing and swallowing, and that her speech was not normal. A CT scan showed a neck tumor affecting a cranial nerve associated with the left common carotid and internal jugular vein. What nerve(s) is (are) MOST LIKELY affected? A. Facial nerve B. Glossopharyngeal nerve C. Hypoglossal nerve D. Maxillary division of the trigeminal nerve E. Preganglionic sympathetic nerves F. Vagus nerve

F. Vagus nerve