HEAD AND NECK

7. The rhomboid-shaped junction of the frontal, coronal, and sagittal sutures in the neonate. a. Anterior fontanelle b. Posterior fontanelle c. Sphenoidal fontanelle d. Mastoid fontanelle

a. Anterior fontanelle *Largest *Closes at 1-2 years old

78. An abscess was surgically removed from the middle of the posterior triangle on the right side. During recovery the patient noticed that her shoulder drooped and she could no longer raise her right hand above her head to brush her hair. Which nerve is affected. a. CN XI b. CN XII c. Ansa cervicalis d. CN X

a. CN XI

55. The triangle in which the superior branch of the ansa cervicalis separates from the hypoglossal nerve is the: a. Carotid b. Muscular c. Subclavian d . Submental

a. Carotid

59. The infrahyoid muscles are innervated by: a. Cervical roots 1,2,3 b. CN XI c. CN XII d. CN VII

a. Cervical roots 1,2,3

88. A patient with foul rhinorrhea, maxillary pain on the right with fever consults you. He was seen by another MD and CT scan was done. What sinus abnormality is clearly demonstrated in this CT scan of the PNS? a. Concha bullosa b. Maxillary sinusitis c. Normal PNS CT scan d. none of the above

a. Concha bullosa

3. A non-movable, fibrous joint joining the frontal and parietal bones. a. Coronal Suture b. Sagittal Suture c. Lambdoid Suture d. Metopic Suture

a. Coronal Suture

54. Which of the following is not an action of the trapezius? a. Elevation of scapula b. Rotation of scapula c. Retraction of scapula d. Depression of scapula

a. Elevation of scapula

72. Which of the following gives the main blood supply of the tonsils? a. Facial b. Ascending Pharyngeal c. Lingual d. Inferior Thyroid

a. Facial

27. Which of the following protrude the tongue: a. Genioglossus b. Styloglossus c. Palatoglossus d. Hyoglossus

a. Genioglossus

80. A 29 year old man was brought into the emergency room with a stab wound in the upper part of the neck. Although there was no major damage done. He lost sensation from the skin over the angle of the jaw. Which nerve has been cut? a. Greater Auricular b. Suprascapular c. Transverse cervical d. Greater occipital

a. Greater Auricular

33. Type of teeth used to cut food without the application of force: a. Incisors b. Canine c. Pre molars d. Molars

a. Incisors

44. Which among the following belongs to the most superficial of the deep cervical fascia? a. Investing Fascia b. Vertebral Fascia c. Visceral Fascia d. Pretracheal Fascia

a. Investing Fascia

67. Which of the following is true about the internal carotid artery: a. It does not give off any branches in the neck b. It crosses by the lingual nerve c. It crosses by the anterior belly of the digastric d. It passes by the skull base

a. It does not give off any branches in the neck

81. An ENT surgeon experiences extensive bleeding while performing complicated endoscopic intranasal surgery. 1 day after surgery, he noted a hematoma at the medial canthal area of his patient's left eye that limits the patient's range of orbital motion. What structure is most likely to have been damaged or penetrated. a. Lamina Papyracea b. Skull base c. The nasal septum d. Cribriform plate of the ethmoid

a. Lamina Papyracea

12. This layer of the scalp allows for the free movement of the scalp proper. a. Loose areolar tissue b. Periosteum c. Connective tissue d. Aponeurosis

a. Loose areolar tissue *Periosteum: attached to calvaria; continuous with endosteum *CT: blood supply * Aponeurosis: attachement point of occipitofrontalis muscle

15. This muscle extends from the zygomatic arch to the lateral surface of the mandibular ramus, and is responsible for clenching the teeth and raising the lower jaw. a. Masseter Muscle b.Temporalis Muscle c. Lateral Pterygoid Muscle d. Medial Pterygoid Muscle

a. Masseter Muscle *temporalis: accessory muscle for chewing; retratcs mandible *Lateral pterygoid muscle: protude mandible and perform side movements *Medial pterygoid: Elevate the mandible

98. What is the final Common Pathway of Paranasal sinus Drainage particularly the Frontal Sinus, Anterior Ethmoids and Maxillary Sinus. a. Osteomeatal unit b. Spheno-ethmoidal recess c. Frontal recess d. Superior meatus

a. Osteomeatal unit

34. Which of the following salivary glands secrete mostly serous: a. Parotid b. Submandibular c. Sublingual d. Von Ebner's

a. Parotid

85. Your patient visits your clinic due to the swelling and cellulitis between his orbits. CT of the sinuses showed an abscess formation of the nasal septum encroaching onto the upper lips. You advised emergency admission for aggressive medical/surgical management and the patient asked you for the indication for admission your reply is... a. Possibility of Cavernous Sinus Thrombophlebitis b. Cosmetic Deformity c. Patient Treatment Compliance d. Patient Convenience

a. Possibility of Cavernous Sinus Thrombophlebitis

51. What structure in the neck that divides it into the anterior and posterior triangle? a. SCM b. Trapezius c. Omohyoid d. Digastric

a. SCM

60. Which of the following is not innervated by the ansa cervicalis? a. Stylohyoid b. Sternohyoid c. Sternothyroid d. Omohyoid

a. Stylohyoid

18. These groups of lymph nodes drain the upper lip, and the lateral part of the lower lip. a. Submandibular nodes b. Submental nodes c. Parotid nodes d. Superficial cervical nodes

a. Submandibular nodes *Parotid nodes: Lateral face *Submental: center lower lip

23. Severe infection of the second and third mandibular molar will spread first to which of the following: a. Submandibular space b. Maxillary sinus c. Sublingual space d. Buccal space

a. Submandibular space

42. What is the most superficial layer of the cervical fascia? a. Superficial Cervical Fascia b. Deep Superficial Cervical Fascia c. Deep Middle Cervical Fascia d. Deep Layer of the Deep Cervical Fascia

a. Superficial Cervical Fascia

75. Which of the following is not a tributary of the internal jugular vein: a. Superior Petrosal sinus b. Retromandibular vein c. Facial vein d. Lingual vein

a. Superior Petrosal sinus Inferior petrosal sinus Common facial vein Lingual vein Superior and Middle thyroid vein

25. Which muscles retract the mandible: a. Temporalis b. Masseter c. Medial Pterygoid d. Lateral Pterygoid

a. Temporalis

89. A patient consults you with anterior epistaxis. You are taught in 1st aid class to pinch the nose and apply digital pressure onto the nasal ala. What area are you applying to help control the bleeding? a. The Little's area b. Jacobson's area c. Pyriform aperture d. Perpendicular ethmoidal plate area

a. The Little's area

96. A patient with a dental infection consults you for headache, fever, nausea and vomiting. He is toxic looking , weak and has signs of a central nervous infection. What is the possible posterior route of ascending infection to the CNS/cavernous sinus. a. Via pterygoid plexus b. Via facial vein c. Via middle thyroid vein d. Via jugular vein

a. Via pterygoid plexus

46. What does the superficial cervical fascia allow the neck to do? a. allows the skin to move independent of the deeper structures b. protects the deeper structures of the neck c. provides warmth for the neck d. provides sensation to the neck

a. allows the skin to move independent of the deeper structures

52. Which among the following is not an attachment of the SCM? a. Sternal head of the clavicle b. Acromial head of the clavicle c. Manubrium d. Sternal head

b. Acromial head of the clavicle

90. The blood supply of the nasal septum has contributions from the external and internal carotid artery systems. What arteries mentioned are branches that specifically supply the nasal septum. a. Maxillary artery, lingual artery, temporal artery b. Anterior ethmoidal artery, posterior ethmoidal artery, sphenopalatine artery c. Superior labial artery, ascending pharyngeal artery, tonsillar artery d. Middle meningeal artery, circle of willy's, basilar artery

b. Anterior ethmoidal artery, posterior ethmoidal artery, sphenopalatine artery

1. The skull is a mainly immobile structure, except for two sites of synovial articulation. One of these is the a. Zygomaticomaxillary suture b. Atlanto-occipital joint c. Temporo-mandibular suture d. Frontal bone, anterior table

b. Atlanto-occipital joint

20. Of the five branches of facial nerve, this branch is responsible for innervating the orbicularis oris a. Marginal mandibular branch b. Buccal branch c. Cervical branch d. Zygomatic branch

b. Buccal branch *Temporal branch: frontalis, orbicularis oculi and corrugator supercilli *Zygomatic branch: orbiculariqs oculi *Mandibular: mentalis *Cervical: platysma

87. An intoxicated motorcycle ride hit his face on the curb while texting while riding his vehicle and suffered facial fractures. What is the diagnostic imaging of choice for trauma of the PNS and facial bones. a. MRI b. CT SCAN c. Plain radiographs d. Ultrasound

b. CT SCAN

58. Which triangle of the neck contains a baroreceptor? a. Muscular b. Carotid c. Submandibular d. Submenta

b. Carotid

39. Nasopharynx is lined by: a. Squamous epithelium b. Ciliated columnar epithelium c. Glandular epithelium d. Pavement epithelium

b. Ciliated columnar epithelium

17. Sensory innervation of the face is mainly supplied by this cranial nerve: a. Cranial Nerve IV b. Cranial Nerve V c. Cranial Nerve VI d. Cranial Nerve VII

b. Cranial Nerve V

29. Which nerve provide somatic motor innervation to the tongue muscles: a. Lingual b. Hypoglossal c. Alveolar d. Glossopharyngeal

b. Hypoglossal

30. All of the following provide sensory innervation to the tongue except: a. Lingual b. Hypoglossal c. Chorda Tympani d. Glossopharyngeal

b. Hypoglossal

11. This foramen in the posterior cranial fossa transmit cranial nerve IX, cranial nerve X, and cranial XI. a. Foramen ovale b. Jugular Foramen c. Hypoglossal canal d. Foramen magnum

b. Jugular Foramen *Foramen ovale: pierces the middle cranial fossa and transmit V3 and accesory meningeal artery' *Hypoglossal canal: cranial nerve 12 *Foramen magnum: spinal cord, vertebral artery, anterior and posterior spinal arteries

28. What is the main blood supply of the tongue: a. Ascending Pharyngeal b. Lingual c. Maxillary d. Facia

b. Lingual

62. The pretracheal space, deep to the pretracheal fascia, surrounds the trachea and thyroid gland, but is anterior to the esophagus. Infection in this space may track into the_____? a. Superior b. Middle c. Posterior d. Inferior

b. Middle

63. The pretracheal space, deep to the pretracheal fascia, surrounds the trachea and thyroid gland, but is anterior to the esophagus. Infection in this space may track into the ____? a. Superior b. Middle c. Posterior d. Inferior

b. Middle

71. What is the fifth branch of the external carotid artery? a. Lingual b. Occipital c. Posterior Auricular d. Inferior Thyroid

b. Occipital *superior thyroid *ascending pharyngeal *lingual artery *Facial artery *Occipital *posterior auricular artery *terminal branches

61. Which area most directly communicates with the retropharyngeal space, and is located to the pharynx? a. Retropharyngeal space b. Parapharyngeal space c. Danger space d. Posterior cervical space

b. Parapharyngeal space

94. A patient with maxillary and frontal and ethmoidal sinus pain, fever and foul muco purulent rhinorrhea consults you. What will be a likely finding during your PE intranasally? a. Clear watery nasal discharge b. Purulent mucoid discharge at the middle meatus c. Epiphora d. Hyperacusis

b. Purulent mucoid discharge at the middle meatus

4. A non-movable, fibrous joint joining the parietal bone with its contralateral counterpart. a. Coronal Suture b. Sagittal Suture c. Lambdoid Suture d. Metopic Suture

b. Sagittal Suture

32. Which of the following types of taste buds is the canonical taste receptor cell: a. Type I b. Type II c. Type III d. Type IV

b. Type II

43. What is the deepest layer of the deep cervical fascia that covers the vertebral columns? a. Investing Fascia b. Vertebral Fascia c. Visceral Fascia d. Pretracheal Fascia

b. Vertebral Fascia

36. What structure theoretically divides the parotid into the superficial and deep lobe a. retromandibular vein b. stensen's duct c. facial nerve d. buccal fat pad

b. stensen's duct

65. Which of the following is not contained inside the carotid space? a.Carotid artery b.External Jugular vein c.Vagus nerve d.Internal Jugular vein

b.External Jugular vein

16. The uppermost segment of the facial vein which facilitates the spread of infection from the face into the cavernous sinus. a. Labial vein b. Lateral nasal vein c. Angular Vein d. Supratrochlear vein

c. Angular Vein

53. Which among the following is not an attachment of the trApeziuS? a. Acromion process b. Scapula c. Anterior border of the clavicle d. All of the above

c. Anterior border of the clavicle

37. All of the following are boundaries of the nasopharynx except: a. Skull base b. Posterior choanae c. Base of tongue d. Soft palate

c. Base of tongue

6. The junction of the coronal suture and the sagittal suture is called the a. Lambdoid suture b. Metopic suture c. Bregma d. Lambda

c. Bregma

40. oropharynx extends up to: a. C2 b. C3 c. C4 d. C5

c. C4

50. What is the innervation of the SCM? a. CN IX b. CN X c. CN XI d. CN XII

c. CN XI (accessory nerve)

8. The premature closure of the fontanelles in the skull leads to restriction of skull growth associated with morphological changes and deformities. This condition is known as: a. Hydrocephalus b. Anencephaly c. Craniosynostosis d. Pierre-Robin Syndrome

c. Craniosynostosis *

10. This foramen in the middle cranial fossa transmits cranial nerve V2 a. Superior orbital fissure b. Foramen lacerum c. Foramen rotundom d. Foramen spinosum

c. Foramen rotundom *Superior orbital fissure: Cranial nerve 3,4, v1, 6, ophthalmic veins *Foramen Spinosum: Middle meningeal artery and V3 * Foramen LAcerum: does not transmit any veins

68. Which of the following is true about the external carotid artery? a. It crosses deep to the styloglossus muscle b. It has 2 layers c. It begins at the level of the Hyoid bone d.It is the main blood supply of the brain

c. It begins at the level of the Hyoid bone

2. A non-movable, fibrous joint joining the parietal and occipital bones. a. Coronal suture b. Sagittal suture c. Lambdoid suture d. Metopic suture

c. Lambdoid suture

41. The neck is bounded superiorly by the: a. Maxilla b. Hyoid Bone c. Mandible d. SCM

c. Mandible

91. The Ohngren's line is a landmark based line used to prognosticate maxillary sinus cancer. It is determined by landmarks from the... a. Nasal tip to the mentum b. Mastoid tip to the angle of the mandible c. Medial canthus to angle of the mandible d. Superior nasal spine to the glabella

c. Medial canthus to angle of the mandible

84. Your patient consulted you for fever congestion and plural and nasal discharge with facial pain and CT scan of the sinus is showed pansinusitis involving the frontal maxillary, and anterior ethmoid sinuses the most likely compromised structure anatomically obstructed is the a. Sphenoid Ostium b. Frontal Recess c. Middle Meatus d. Facial Vein

c. Middle Meatus

31. All of the following are innervated by the hypoglossal nerve, EXCEPT: a. Genioglossus b. Styloglossus c. Palatoglossus d. Hyoglossus

c. Palatoglossus

45. Which of the following is invested in the superficial cervical fascia? a. SCM b. Omohyoid c. Platysma d. Digastric

c. Platysma

93. Mucus production and also muco-ciliary clearance is made possible by the epithelial lining of the paranasal sinuses. In particular the lining is... a. Simple squamous non ciliated epithelium b. Simple cuboidal secretory epithelium c. Pseudostratified columnar epithelium with goblet cells d. Non-keratinizing squamous epithelium

c. Pseudostratified columnar epithelium with goblet cells

77. In repairing a damaged right subclavian artery, the surgeon notices and protects a large nerve passing around to the posterior surface of the artery. This nerve, which does not encircle the subclavian on the left side is the: a. Phrenic b. Vagus c. Recurrent Laryngeal d. Ansa Cervicalis

c. Recurrent Laryngeal

79. Which muscle is innervated by a branch of the ansa cervicalis? a. SCM b. Platysma c. Sternohyoid d. Trapezius

c. Sternohyoid

22. Severe infection of the first mandibular molar will spread first to which of the following: a. Submandibular space b. Maxillary sinus c. Sublingual space d. Buccal space

c. Sublingual space

74. The branch of the external carotid artery that majorly supplies the scalp: a. Facial b. Occipital c. Superficial temporal d. Internal Maxillary

c. Superficial temporal

70. Which structures lie immediately anterior to the right anterior scalene muscle at its costal attachment? a. Subclavian artery b. Subclavian vein c. Thoracic duct d. Vagus nerve

c. Thoracic duct

99. A medical student disinfected his hands with 70% isopropyl alcohol. He suddenly covered his nose to smell his hands. You noted that he withdraws and frowns and coughs. What cranial nerve is stimulated by this action? a. Facial nerve b. Vagus nerve c. Trigeminal nerve d. Olfactory nerve

c. Trigeminal nerve

35. What immunoglobulin is found in saliva a. lgM b. lgG c. lgA d. lgE

c. lgA

48. What does deep fascia consists? a.Connective tissue b.Fat c.Fibrous tissue d.A & B e.C & D

c.Fibrous tissue

47. What composes the superficial cervical fascia? a. Connective tissue b. Fat c. Fibrous tissue d. A & B e.C &; D

d. A & B

57. Which of the following is contained in the submandibular triangle of the neck? a. Facial artery b. Facial vein c. Submandibular gland d. All of the abov

d. All of the above

64. The carotid sheath is formed by which fascia: a. Superficial Deep Cervical Fascia b. Middle Deep Cervical Fascia c. Deep layer of the Deep Cervical Fascia d. All of the above

d. All of the above

97. Paranasal sinuses PARTLY SUPPLIED BY THE INTERNAL CAROTID ARTERY SYSTEM a. Frontal sinus b. Ethmoid sinus c. Sphenoid sinus d. All of the above

d. All of the above

14. This muscle of facial expression draws the eyebrows inferomedially. It originates from the inferior part of the frontal bone, and inserts to the skin deep to the medial eyebrow. What is its innervation? a. Cranial Nerve V b. Cranial Nerve IX c. Cranial Nerve XI d. Cranial Nerve VII

d. Cranial Nerve VII *corrugator supercilli

9. This bone contributes to the medial wall of the orbit, the nasal septum, the roof of the nasal cavity, and the lateral nasal wall. a. Sphenoid b. Orbital c. Maxillary d. Ethmoid

d. Ethmoid

86. What is the most likely pathway of infection to the cavernous sinus in a patient with facial cellulitis? a. Superficial temporal artery b. Common carotid artery c. Internal jugular vein d. Facial vein

d. Facial vein

38. Passavant's ridge is formed by: a. Middle constrictor muscles b. Inferior constrictor muscles c. Posterior ⅓ of tongue d. Fibers of superior constrictor and palatopharyngeus muscle

d. Fibers of superior constrictor and palatopharyngeus muscle

26. Which of the following depresses the tongue: a. Genioglossus b. Styloglossus c. Palatoglossus d. Hyoglossus

d. Hyoglossus *genioglosus: protudes apex of tongue *Styloglosus: draws tongue upward *PalatoglosusL pulls roots of tongue upward and downs

69. Which statement is true about the internal jugular vein: a. It drains all of the thyroid glands in that side of the body b. It drains into the external jugular vein c. It lies deep into the prevertebral fascia d. It is accompanied by the deep cervical chain of lymph nodes

d. It is accompanied by the deep cervical chain of lymph nodes

24. Which of the following does not elevate the mandible: a. Temporalis b. Masseter c. Medial Pterygoid d. Lateral Pterygoid

d. Lateral Pterygoid

5. A non-movable, fibrous joint which represents a persistent frontal suture a. Coronal suture b. Sagittal suture c. Lambdoid suture d. Metopic suture

d. Metopic suture

95. Muco-ciliary flow and clearance of the para nasal sinuses naturally drains via.. a. Random directional flow b. Static flow c. Gravity dependent flow d. Natural ostia of the PNS

d. Natural ostia of the PNS

19. The action of the lateral pterygoid muscle is: a. Elevation of the mandible b. Depression of the mandible c. Supports floor of oral cavity d. Protrusion of the mandible

d. Protrusion of the mandible

13. This continuous layer of fascia encases and connects all of the muscles of facial expression with the overlying skin through fibrous bands. a. Platysma b. Temporal Fascia c. Fibroadipose tissue d. SMAS

d. SMAS

92. A novice ENT surgeon encountered difficulty in orienting himself during sinus surgery. Upon superior dissection of the ethmoidal sinus area. Clear to straw colored fluid began to ooze out of his surgical field. It was determined that the fluid is CSF. What structure was compromised during the surgery that SEPARATES THE ETHMOID SINUSES FROM THE ANTERIOR CRANIAL FOSSA? a. FOVEA ETHMOIDALIS b. SPHENO ETHMOIDAL RECESS c. FRONTAL SINUS d. SPHENOID SINUS

d. SPHENOID SINUS

83. This sinus is penetrated during intranasal sinus surgery may produce blindness and fatal bleeding due to it being intimately related to the optic nerve and internal carotid artery. a. Maxillary sinus b. Ethmoidal recess c. Frontal sinus d. Sphenoid sinus

d. Sphenoid sinus

76. A muscular patient who regularly lifts weight presents with pain and weakness in his right upper limb that has been slowly developing over time. His limb is cool and there is an obvious vascular insufficiency in his upper extremity. Subsequent test shows that a large vessel passing between the anterior and middle scalene muscles is being occluded by hypertrophy of the muscles due to exercise. The artery involved is the: a. Axillary b. Brachial c. Brachiocephalic d. Subclavian

d. Subclavian

73. Which of the following is true about the thyrocervical trunk: a. One of its branches is the Superior Thyroid artery b. Arises from the second part of the subclavian artery c. Enters the thyroid at the level of the Hyoid d. Supplies the inferior pole of the thyroid gland

d. Supplies the inferior pole of the thyroid gland

82. A patient working at a chemical plant claiming compensation for work related anosmia, You were tasked to determine the authenticity of his claim. He declares that he cannot smell coffee nor tobacco. But as you introduce the spirit of ammonia to his nose, he withdraws vigorously due to disturbing intranasal pain. These findings prove that... a. The patient is lying b. It is false anosmia c. The olfactory nerve is intact d. The trigeminal nerve is intact

d. The trigeminal nerve is intact

21. Which of the oral cavity subsites has the most common occurrence of malignancy a. Lip b. Buccal mucosa c. Retromolar trigone d. Tongue

d. Tongue

56. A patient is brought into the emergency room in respiratory distress. It is quickly decided to create an emergency airway to restore respiration. At what level could you rapidly create an airway below the vocal cords with minimum danger of hemorrhage? a. just above the jugular notch b. just above the thyroid cartilage c. just below the cricoid cartilage d. just below the thyroid cartilage

d. just below the thyroid cartilage *Cricothyrotomy, emergency opening made in the cricothyroid membrane below the thyroid cartilage and above the cricoid cartilage."

49. What structures does the visceral fascia surround? a.Trachea b.Esophagus c.Thyroid d.All of the above

d.All of the above

66. Which of the following is not true about the common carotid artery? a.The right CCA arises from the aortic arch b.The left CCA arises from the brachiocephalic artery c.It crosses by the SCM d.All of the above

d.All of the above