PrepU Head and Neck

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Buccinator muscle

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?

fibers of cells located in the trigeminal ganglion.

The infraorbital groove contains __________________.

Trigeminal Nerve (CN V)

The muscles that are of branchiomeric origin are paralyzed in a 26-year-old patient. A lesion of which of the following nerves would cause muscle dysfunction?

Trigeminal nerve

The muscles that are of branchiomeric origin are paralyzed in a 26-year-old patient. A lesion of which of the following nerves would cause muscle dysfunction?

inferior meatus.

The nasolacrimal duct drains into the ______________.

Inability to protrude the tongue (this is hypoglossal nerve (CNXII))

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?

Directly anterior to the terminal sulcus on the tongue

Vallate papillae are taste receptors located where?

Normal fusion of sagittal suture

What do the arrows in the above figure show?

Posterior cricoarytenoid

Which of the following laryngeal muscles abducts the vocal folds?

Sphenoid sinus via the pterygoid canal (The pterygopalatine fossa does not communicate with the sphenoid sinus.)

Which of the following regions does not communicate with the pterygopalatine fossa via the indicated route?

Ophthalmic division of trigeminal nerve

While participating in a bar fight, the orbit of a 25-year-old man is pierced by a broken pool cue stick, which extends back to the superior orbital fissure. Which of the following nerves is most likely damaged?

Cribriform plate

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?

internal laryngeal nerve - located directly deep to the mucosa of the piriform recess and is liable to injury from a swallowed sharp object such as a chicken bone.

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?

Carotid sinus hypersensitivity

You are in the ED about to check an accident patient's carotid pulse when the attending physician corrects your finger place by lowering it. The attending physician notes that you need to keep your fingers low because certain patients have which of the following?

Cleft palate

You are serving as a medical aide in an undeveloped country and your supervisor brings you the above CT of a newly arrived female patient. What is your diagnosis?

Palatine (bc this was only option that was not an orbital margin bone)

Your 19-year-old male patient was punched in the orbit and has sustained a fracture of one of the bones that form the orbital margin. Which of the following bones would you not expect to have sustained a fracture?

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

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 papilloma on her left vocal fold

Your 35-year-old patient is having difficulty speaking. A photograph of her larynx taken during a laryngoscope exam is shown above. What does it reveal?

Lingual nerve of CN V3

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?

The Soft Palate

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?

Trochlear

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?

Troclear Nerve (IV)

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?

Glossopharyngeal (IX)

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?

Ophthalmic

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?

Nasociliary nerve (branch of the opthalamic nerve)

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?

Hypoglossal Nerve (CN XII)

A 22-year-old man receives a stab wound in the left anterior cervical region, at the C2 vertebral level. The wound was 3 cm deep and located anterior to the sternocleidomastoid muscle (SCM) and superior to the greater horn of the hyoid bone. During a postoperative examination, the patient displays dysarthria, or difficulty speaking. Which of the following structures is most likely damaged?

Accessory Nerve (CN XI)

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?

Entrapment of inferior rectus muscle

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?

Second pharyngeal arch -(asymmetry due to an absence/underdevelopment of the platysma muscle - All the facial muscles are derived from the mesoderm of the second pharyngeal (hyoid) arch and are innervated by the facial nerve (CN VII). Additional muscles derived from the second arch include the posterior belly of the digastric, stylohyoid, and stapedius)

A 25-year-old woman notes the pictured asymmetry in her neck when she tenses the skin of her inferior face and neck. This asymmetry may be due to a limited mesodermal migration in which of the following embryonic structures?

Right vagus nerve

A 26-year-old woman with the flu comes to an outpatient clinic. On examination, a physician diagnoses her with sinus and palate infection, and her uvula deviates to the left side on phonation. Which of the following nerves is injured?

Brainstem and sacral spinal cord

A 27-year-old paratrooper lands on a pine tree. Consequently, preganglionic parasympathetic nerves leaving the central nervous system are lacerated. Which of the following structures contain cell bodies of the damaged nerve fibers?

Lack of parotid gland secretion

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?

Muscular torticollis resulting from injury of the sternocleidomastoid (SCM) muscle at birth

A 3-year-old boy asked his mother why his head was tilted to the side. His mother took him to a pediatrician because she thought he might have injured his neck. The deformity developed after delivery. The pediatrician found that the cervical region of the boy's vertebral column was permanently held in a position of slight left lateral flexion (bending). She also observed that his head was tilted to the left side with his occiput rotated toward his shoulder. Furthermore, she detected a palpable pea-sized mass in the inferior aspect of a protruding muscle. AP and lateral radiographs of the boy's neck were normal as were the deep cervical lymph nodes. Which of the following statements best describes the most likely cause of the boy's twisted neck?

Trigeminal Nerve (CN V)

A 32-year-old house painter suffers from a head injury after falling off a ladder and has bleeding in his head. During intraoperative testing, the neurosurgeon notes loss of general sensation in the dura of the middle cranial fossa. Which of the following nerves has been affected?

Mylohyoid

A 32-year-old man presents with unilateral paralysis of the muscles of mastication on the right side. This condition has resulted in facial asymmetry as noted in the figure. Though he is uncomfortable with his appearance and has difficulty when chewing his food, his chief complaint is his difficulty swallowing (dysphagia). What muscle is most likely involved in his dysphagia?

Injury of the spinal accessory nerve (CN XI)

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?

Absence of the corneal blink reflex

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?

C (optic chiasm)

A 33-year-old woman presents with rapid weight gain, particularly in the trunk and face with sparing of the limbs, excess sweating, thinning of the skin, and hirsutism (facial male-pattern hair growth). A full examination also reveals bitemporal hemianopsia (or tunnel vision). What of the following labeled areas on the given X-ray of the lateral skull will be of most interest to the physician?

C

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?

C (middle nasal meatus)

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?

Facial, glossopharyngeal, and hypoglossal nerves

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?

Dryness in the nose and palate

A 37-year-old man receives a direct blow to his head and is brought to an emergency department. His radiograph shows a fracture of the floor of the middle cranial cavity, causing severance of the greater petrosal nerve. Which of the following conditions could be produced by this injury?

Abducent nerve (CN VI)

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?

Superior petrosal sinus

A 39-year-old woman presents to your clinic with complaints of headache and dizziness. She has an infection of a cranial dural sinus. The sinus that lies in the margin of the tentorium cerebelli and runs from the posterior end of the cavernous sinus to the transverse sinus is infected. Which of the following sinuses is affected by inflammation?

Taste in the anterior two thirds of the tongue

A 40-year-old woman suffers from headaches, nausea, vomiting, and multiple lower cranial nerve involvement. Her physician orders a CT soft tissue neck study, and the given coronal CT shows a mass lesion (tumor) centered at the jugular foramen and identified by arrows. This tumor has destroyed the jugular foramen and hypoglossal canal on the right side and damaged the cranial nerves traversing these foramina. In this patient, which of the following functions will remain intact?

Blockage of the right submandibular duct

A 42-year-old man visited his primary care physician because of a swelling in his mouth and pain under his tongue. The physician examined his mouth and observed that there was inflammation and swelling around his right sublingual caruncle. When she asked the patient when he feels the pain, he said it occurs mostly when he eats. A CT exam revealed a large calculus (stone) in a structure under the tongue. Which of the following statements best describes the most likely cause of the sublingual swelling in the man's mouth?

Superior cervical ganglion (this is known as Horner's Syndrome)

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?

internal acoustic meatus (CN VII Facial)

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?

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?

inferior oblique

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?

Third division of trigeminal nerve

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?

Vertebral artery

A 50-year-old man presents with recurring dizziness, ataxia, vertigo, aphasia, and weakness in his right upper limb. A magnetic resonance angiogram (MRA) revealed a stenosis of the right subclavian artery (marked by the arrow) and poststenotic dilatation, which led to the diagnosis of subclavian steal syndrome. In this condition, blood is shunted from the left side arterial tree via collateral flow into the right side circulation. Through which of the following ipsilateral vessels is blood entering the right subclavian artery distal to the stenosis?

Internal acoustic meatus

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?

Absorb CSF into the dural venous sinuses

A 59-year-old man has pus in the loose connective tissue layer of the scalp, and consequently, his superior sagittal sinus is infected. The arachnoid granulations in the infected sinus:

lateral pterygoid muscle

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?

Ophthalmic artery

A 61-year-old woman is found to have ocular lymphoma invading her optic canal. Which of the following structures would most likely be damaged?

Sphenopalatine artery

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 nerve proximal to the geniculate ganglion

A 67-year-old man is complaining to his physician of immediate lacrimation (tearing) during eating. He also told his physician that he had had a severe and long-lasting episode of Bell palsy. The physician recognized the syndrome as "crocodile tears syndrome" that results because of misdirection of regenerating autonomic nerve fibers. Which of the following nerves has been injured?

Sphenoid sinus

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?

Pharyngeal tonsils (adenoids)

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?

Inferior laryngeal nerves (also known as recurrent laryngeal nerve)

A 76-year-old man with swallowing difficulties undergoes imaging for a possible mass. The CT scan image at the level of the cricothyroid ligament in his neck should show which of the following structures?

Auriculotemporal nerve

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?

Foramen ovale

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?

Ability to shrug the shoulders

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

greater petrosal nerve

A neuroma at the entrance to the internal acoustic meatus could impinge upon all the following structures except?

Esophageal Atresia and Tracheoesophageal Fistula

A newborn infant was referred to a pediatrician because she was coughing and choking when attempts were made to feed her. The referring physician stated that the infant became cyanotic when she was coughing. Suctioning of excess secretions from the mouth and pharynx resulted in some improvement, but the symptoms quickly recurred. Attempts to insert a catheter into the stomach were unsuccessful. Radiographic studies revealed that the stomach was distended with air. Which of the following statements best describes the most likely cause of the infant's symptoms and signs?

Trigeminal

A patient comes to her physician complaining of burning the anterior aspect of her tongue following drinking an extremely hot cup of coffee. Which cranial nerve is most likely responsible for the pain she is feeling?

Fourth

A physician examines a 53-year-old woman and notes deviation of the uvula to the right and asymmetry in the elevation of the soft palate, with the palatal arch of the left side sagging when compared to the right. The muscles involved in these abnormal findings are most likely derived from the mesoderm of what pharyngeal arch?

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

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?

Zygomaticus major

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?

Arterial supply to the dura mater is reduce

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?

greater petrosal nerve explanation: The greater petrosal nerve carries parasympathetic (preganglionic) fibers, which are secretomotor fibers, to the lacrimal glands and mucous glands in the nasal cavity and palate

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?

Pterygopalatine ganglion

A young girl complains of dryness of the nose and the palate. This would indicate a lesion of which of the following ganglia?

Posterior cricoarytenoid muscle

A young singer at the local music theater visits her physician and complains of vocal difficulties. On examination, she is unable to abduct the vocal cords during quiet breathing. Which of the following muscles is most likely paralyzed?

Orbicularis oris

After ingesting a toxic substance found in her friend's home, a 12-year-old girl is unable to close her lips. Which of the following muscles may be paralyzed?

Thyroglossal duct cyst

An 18-year-old woman presents with a soft, smooth, and fluctuant mass (swelling) in the midline of her neck, situated just below the body of hyoid bone. She first noticed this swelling three years ago, and it has gradually increased in size, measuring 0.5 in. (1.25 cm) in diameter. The physician notes the mass moves upward on swallowing, but no other abnormal findings were discovered. What is the most likely diagnosis in this patient?

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?

Abducens (CN VI)

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?

suprascapular nerve

An anesthesiologist is about to perform a cervical plexus block prior to surgery. She injects the anesthetic agent at several points directly posterior to the sternocleidomastoid, especially at the "nerve point." Which of the following nerves would likely not be affected by this procedure?

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.)

An infection in which of the following paranasal sinuses is most likely to be associated with optic neuritis?

Opening of the parotid duct

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?

C (The geniohyoid muscle is innervated by the first cervical nerve through the hypoglossal nerve.)

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 (nasal septum)

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?

B (Optic Nerve CN II)

Choose the appropriate lettered structure in this MRI scan showing a transaxial section through the head (see figure). Which structure mediates the afferent limb of the pupillary light reflex?

A (The posterior cerebral artery provides the blood supply to the midbrain and the temporal and occipital lobes of the cerebrum.)

Choose the appropriate lettered structure in this angiogram of the cerebral vasculature (see figure). Collateral circulations are discounted. A blockage of which artery may cause ischemia of the midbrain and the temporal and occipital lobes of the cerebrum?

C (The anterior cerebral artery supplies the frontal lobes and medial aspects of the parietal and occipital lobes.)

Choose the appropriate lettered structure in this angiogram of the cerebral vasculature (see figure). Collateral circulations are discounted. A lesion of which artery may cause oxygen deficiency to the medial surface of the frontal and parietal lobes of the brain?

E (The posterior inferior cerebellar artery supplies the posterior inferior surface of the cerebellum.)

Choose the appropriate lettered structure in this angiogram of the cerebral vasculature (see figure). Collateral circulations are discounted. Ischemia of the posterior inferior surface of the cerebellum is caused by obstruction of which artery?

Middle pharyngeal constrictor (The middle constrictor arises from the greater and lesser horns of the hyoid bone. Thus, fracture of the hyoid disrupts the compressive action of the middle pharyngeal constrictor muscle in swallowing (or deglutition).)

During a mixed martial arts (MMA) fight, one fighter punched his opponent in the anterior neck, resulting in a fracture of the hyoid bone. Which of the following muscles would be most directly affected by this injury?

Genioglossus muscle

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?

Oculomotor Nerve (CN III)

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?

Costocervical trunk

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?

Trigeminal nerve

Following radical resection of a primary tongue tumor, a 72-year-old patient has lost general sensation on the anterior two-thirds of the tongue. This is probably due to injury to branches of which of the following nerves?

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?

Philtrum (groove above lip)

Holoprosencephaly is a complex of developmental abnormalities characterized by the loss of midline structures to greater or lesser degrees. The pictured infant suffers multiple aspects of this disorder, including the midline cleft indicated. This specific developmental malformation is termed "premaxillary agenesis," developmental failure of formation of the intermaxillary segment of the face. Which of the following structures is most likely to be affected in this condition?

Feeling at the future site of bregma (explanation: 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.)

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

Unilateral muscles of mastication paralysis (This is the foramen of ovale which contains mandibular nerve (V3) from the trigeminal nerve (CN V))

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

sensation from the anterior 2/3 of the tongue.

Lesion of the lingual nerve proximal to the chorda tympani joining it will lead to loss of _________________.

A

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?

Levator scapulae (origin is transverse processes of C1-C4)

Mrs. Jones was riding in the front seat of her son's van when the vehicle abruptly stopped. Unfortunately, she was not wearing her seatbelt and was thrown forward. As a result of the accident, the transverse processes of her cervical vertebrae were crushed against the dashboard of the van. Which of the following muscles might be paralyzed?

Oculomotor nerve as its exits midbrain

On August 13, 1913, Dr. Edwin Cobb was called to the hospital to see a patient who had been thrown out of a buggy in a runaway accident. The patient was a woman, 46-years-old, and had been unconscious for ten hours when he arrived at the hospital. He noted a small discoloration over the external and superior margins of her right orbit. Upon regaining consciousness the patient showed a complete ptosis of the right lid; widely dilated pupil, with no reaction to light or accommodation, and diplopia was present. The right eye appeared prominent with a slight bulging. What structure is lesioned and where is the most likely location of the lesion?


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