NB 2 Quizzes
A. Otic ganglion Rationale: Preganglionic parasympathetic fibers for the parotid secretion pass through the glossopharyngeal nerve and the parasympathetic postganglionic cell bodies for the parotid gland are located in the Otic ganglion and are relayed to the parotid gland via the auriculotemporal branch of the mandibular nerve. These fibers are responsible for the secretion of saliva from the parotid gland.
A 21-year-old man comes to the physician because of excessive mouth dryness for the past 2-weeks. Physical examination shows white and thick nodules in the mucosa of cheek and floor of the oral cavity. Also, parotid duct is blocked by the nodules. Which of the following structures, responsible for mouth dryness is most likely innervated by? A. Otic ganglion B. Ciliary ganglion C. Pterygopalatine ganglion D. Sympathetic ganglion
B. The maxillary sinus drains into the middle meatus through the semilunar hiatus Rationale: Correct answer: Frontal sinus, maxillary sinus, anterior and middle ethmoid air cells open into middle meatus.Incorrect answers: The superior nasal meatus is connected with the posterior ethmoidal cells. The inferior meatus has an opening for the nasolacrimal duct, which connects the nasal cavity with the orbit. Sphenoethmoidal recess has an opening for sphenoid sinus
A 12-year-old boy is brought to the physician by his mother because of a 3-day history of severe headaches and a feeling of heaviness in the middle part of his face. He has a history of a recent bacterial upper respiratory tract infection. X-rays shows the presence of increased fluid in the frontal and maxillary paranasal sinuses and a diagnosis of sinusitis is made. Which of the following statements best describes the normal drainage of the paranasal sinuses? A. The maxillary sinus drains into the inferior meatus B. The maxillary sinus drains into the middle meatus through the semilunar hiatus C. The frontal sinus drains into the superior meatus D. The anterior and middle ethmoid air cells drain into the sphenoethmoidal recess E. The frontal sinus drains into the inferior meatus through the semilunar hiatus
A. Anterior Rationale: The pharyngotympanic (Eustacian) tube connects the middle ear with the nasopharynx. It opens into the middle ear on the anterior wall and from here it extends forward, medially, and downward to enter the nasopharynx.
A 10-year-old boy is brought to the emergency department by his mother because of a 2-day history of fever, sore throat, and runny nose. He is diagnosed with an upper respiratory tract infection. Physical examination shows diminished hearing and otoscopic examination shows a bulging and inflamed tympanic membrane. The structure that is the direct route for the spread of the infection from the pharynx most likely opens into which wall of the middle ear? A. Anterior B. Posterior C. Medial D. Lateral E. Roof F. Floor
A. Right spinal accessory Rationale: Correct A: The sternocleidomastoid muscle rotates the head to the opposite side. Therefore, since the patient is unable to rotate his head to the left, the right sternocleidomastoid muscle is not functioning. This is innervated by the right spinal accessory nerve. Incorrect:B: the left spinal accessory innervates the left sternocleidomastoid which is not affected in this patient.C & D: The vagus nerve does not innervate the sternocleidomastoid muscles.E: The ansa cervicalis is the motor part of the cervical plexus. It innervates the infrahyoid muscles which includes the omohyoid, sternohyoid and sternothyroid. The thyrohyoid is innervated by C1 via the hypoglossal nerve.
A 15-year-old boy is brought to the physician by his mother because he is unable to rotate his head to the left side. He suffered a stab wound to his neck just posterior to the sternocleidomastoid 3 weeks ago. Which of the following nerves was most likely damaged? A. Right spinal accessory B. Left spinal accessory C. Right vagus D. Left vagus E. Ansa cervicalis
A. Angular vein Rationale: The danger area of the face lies between the deep facial and angular veins. Infection of the upper lip, vestibule of the nose and eyelids spread by way of the angular, supraorbital, and supratrochlear veins to the ophthalmic veins which drain directly into the cavernous sinus.
A 15-year-old girl comes to the physician because of a 24-hour history of headache, facial pain along her cheekbones and vision problems. She has an infected pimple on the ala of her nose which she has been repeatedly pick at. She is diagnosed with cavernous sinus thrombosis. Which of the following veins is the most likely route that introduced the infection to the cranial cavity? A. Angular vein B. Superior sagittal sinus C. Lingual vein D. Superior petrosal sinus E. Internal jugular veins
C. Pterygoid venous plexus Rationale: The pterygoid venous plexus is located in the infratemporal fossa and connect to the cavernous sinus via emissary veins. Therefore, infections can spread from the infratemporal fossa to the cavernous sinus.
A 16-year-old boy is brought to the physician by his parents because of a 1-day history of fever, drowsiness, and a confused mental state. He is admitted to hospital and diagnosed with a cavernous sinus infection and thrombosis resulting from an abscess in the infratemporal fossa. Which of the following is most likely the path taken by the infection from the fossa to the cavernous sinus? A. Ophthalmic vein B. Facial vein C. Pterygoid venous plexus D. Occipital emissary vein E. Maxillary vein
D. Lateral pterygoid Rationale: The lateral pterygoid muscles act bilaterally to protract the jaw and unilaterally to rotate it. Because the fibers of the lateral pterygoid muscle insert on the anterior aspect of the temporomandibular joint's articular disk as well as the head of the mandible, spasm of this muscle, such as during a yawn, can cause dislocation of the mandible by pulling the disk anterior to the articular tubercle. Reduction is achieved by pushing the mandible backwards and downwards until the mandible's head reenters the mandibular fossa.
A 19-year-old man is brought to the emergency department by the paramedics because of difficulty closing his jaw, for past 2 hours. Physical examination shows dislocated mandible. Radiological examinations show mandibular head is displaced beyond the articular tubercle of the temporomandibular joint. Which of the following muscles most likely contracted as a result of this condition? A. Masseter B. Temporalis C. Medial pterygoid D. Lateral pterygoid
A. Visible base of the light reflected towards the anterior aspect Rationale: The cone of light, handle of malleus, umbo, pars tensa, and pars flaccida make up the normal landmarks. The cone of light originates at the umbo and extends anteriorly (this allows the viewer to determine a right from left ear based solely on an otoscopic view)
A 21-year-old man come to the the physician for a general physical examination for insurance purpose. Physical examination is with in normal limits. What is most likely seen on normal tympanic membrane examination? A. Visible base of the light reflected towards the anterior aspect B. Head of the malleus visible C. Stapes footplate visible D. Malleoincudal joint visible E. Chorda tympani nerve visible
B. Omental bursa Rationale: The omental bursa or lesser sac is located posterior to the stomach and anterior to the pancreas. Therefore, since the pancreas is lacerated, and the contents are spilling anterior to it, they will spill into the space anterior to the pancreas, which is the omental bursa.
A 21-year-old woman is brought to the emergency department following a car crash where she impacts the steering wheel. Physical examination shows abdominal bruising and guarding on palpation. Imaging studies show a lacerated pancreas with the digestive enzymes spilling anterior to it. Into which of the following locations will the contents of the lacerated organ most likely spill? A. Supracolic part of the greater sac B. Omental bursa C. Subhepatic bursa D. Infracolic part of the greater sac E. Subhepatic recess
D. Skin, dense connective tissue, aponeurosis Rationale: The first three layers of the scalp - skin, dense connective tissue and the aponeurosis can be considered as the scalp proper and are intimately attached. They can therefore be peeled back as a single layer.
A 22-year-old man is brought to the emergency department because of severe bleeding from a head injury after a car crash. Physical examination shows the three fused layers of the scalp has been peeled back as a single layer. Which of the following layers are most likely involved? A. Skin, aponeurosis, pericranium B. Skin, loose connective tissue, pericranium C. Skin, loose connective tissue, aponeurosis D. Skin, dense connective tissue, aponeurosis E. Skin, loose connective tissue, dense connective tissue
A. Middle meningeal artery Rationale: The middle meningeal artery originates in the infratemporal fossa and ascends through the foramen spinosum into the middle cranial fossa of the cranial cavity. It supplies the dura mater and the skull of the lateral cranial vault. An epidural hematoma is caused by a bleed in the middle meningeal artery.
A 24-year-old man comes to physician's office because he collapsed to the ground after a ball hit right side of his head and was unconscious for about four minutes. Once conscious he experienced with a severe headache and drowsy. Physical examination shows bruise on right temple and dilated right pupil. Radiological examination shows a fracture of the squamous part of the right temporal bone. and an epidural hematoma. Which of the following structures is most likely damaged? A. Middle meningeal artery B. Accessory meningeal artery C. Infraorbital artery D. Sphenopalatine artery
B. Otalgia (ear pain ) Rationale: Otalgia because CN IX and CN X will be involved. CN V3 refers pain to TMJ joint. Inflammation of the epiglottis will lead to narrowing of valleculae. Taste is by CN VII
A 25-year-old man come to the physician because of difficulty and pain when swallowing for past 12 hours. Physical examination shows inflammation of the epiglottis. Which of the following symptoms is most likely associated with his present condition? A. Pain that is referred to the temporomandibular joint (TMJ ) joint B. Otalgia (ear pain ) C. Loss of taste D. Widened valleculae E. Bisected the cricoid cartilage
A. Foramen ovale Rationale: Correct: This is the mandibular division of the trigeminal nerve which enters the infratemporal fossa through the foramen ovale. Incorrect answersB is the maxillary division of the trigeminal nerve enters the pterygopalatine fossa through the foramen rotundum. C and D: The facial nerve exits the cranium via the internal acoustic meatus. The motor branch of the facial nerve exits onto the face via the stylomastoid foramen.E: the inferior alveolar nerve, which is a branch of the mandibular nerve, as well as the inferior alveolarartery, enter the mandibular foramen traveling through the mandibular canal and exit at the mental foramen on the anterior mandible at which point the nerve is known as the mental nerve.
A 25-year-old man comes to the physician because of numbness of the lower lip, left side of his face just anterior to his ear and difficulty chewing his food, for past 5 days. The nerve responsible for innervation to the affected region most likely passes through which of the following foramen? A. Foramen ovale B. Foramen rotundum C. Internal acoustic meatus D. Stylomastoid foramen E. Mandibular foramen
F. Anterior pituitary via hypophyseal portal system Rationale: GnRH is released into the hypophyseal portal system for action on cells of the anterior pituitary, which release gonadotropin.
A 27-year-old man comes to the physician because of a 2-month history of fatigue and decreased libido. A pituitary prolactinoma is diagnosed. The clinical presentation reflects disrupted action of gondadotropin releasing hormone (GnRH). Through which of the following targets and routes does GnRH most likely act? A. Gonads via systemic circulation B. Posterior pituitary via systemic circulation C. Anterior pituitary via systemic circulation D. Gonads via hypophyseal portal system E. Posterior pituitary via hypophyseal portal system F. Anterior pituitary via hypophyseal portal system
A. Left cranial nerve VI Rationale: Cranial nerve VI innervates the lateral rectus muscle, which is responsible for abducting each eye. Damage to this nerve would results in the adduction of the eye.
A 34-year-old man is brought to the emergency department by the paramedics because he was unconscious for a few minutes after a motor vehicle accident, about an hour ago. Physical examination shows left eye is having trouble moving laterally (abduction) from a fully adducted horizontal position. Damage to which cranial nerve will most likely cause this condition? A. Left cranial nerve VI B. Right cranial nerve VI C. Right cranial nerve III D. Left cranial nerve III E. Left cranial nerve VII F. Right cranial nerve VII
B. Greater petrosal nerve Rationale: The greater (superficial) petrosal nerve originates at the geniculate ganglion, where the nervus intermedius and facial nerve join. It contains mainly preganglionic parasympathetic fibers and some sensory taste afferent fibers from the soft palate. After leaving the geniculate ganglion it passes through a small hiatus in the petrous bone to reach middle cranial fossa. It passes towards foramen lacerum where it is joined by the deep petrosal nerve (sympathetic fibers from the internal carotid artery) to form the nerve of the pterygoid canal (Vidian nerve). Hence supplies lacrimal gland for tearing.
A 35-year-old woman comes to physician because of left dry eye and sensation of something in eye, for past six weeks. She had temporal bone fracture six weeks back and is fully recovered. Physical examination shows left eye is dry. Which of the following nerve damage is most likely leading to this condition? A. Lesser petrosal nerve B. Greater petrosal nerve C. Tympanic nerve D. Chorda tympani E. Facial canal
B. B Rationale: Correct answer: B - As the facial nerve travels through the medial and posterior walls of the middle ear, it gives of multiple branches including chorda tympani (taste sensations from anterior two-thirds of the tongue, and parasympathetic innervation to the submandibular and sublingual glands). Other branches are nerve to stapedius muscle (stabilizes the stapes bone to help limit loud noises), and greater petrosal nerve (parasympathetic to lacrimal gland, and the mucous membrane of the nasal cavity and the palate). It then exits through the stylomastoid foramen as the motor branch to the muscles of facial expression. The patient's presentation indicates loss of function of nerve to stapedius, chorda tympani, and the motor branch. A lesion at B, will affect all these branches.Incorrect answers:A - Injuries proximal to origin of greater petrosal nerve at the internal acoustic meatus will present with dry eyes and dry nasal cavity, in addition all of the other symptoms.C - Injuries distal to origin of nerve to stapedius are unlikely to present with hyperacusis.D - Isolated injuries to chorda tympani are unlikely to present with hyperacusis.E - Injury at the stylomastoid foramen will lead to loss of the nasolabial fold. but is unlikely to present with hyperacusis and decreased taste sensation to the anterior 2/3 of the tongue.
A 40-year-old man come to the physician because of a 3-day history of loud sounds, impaired taste sensation and dry mouth. He was struck in the head by flying debris shortly before his current symptoms. Physical examination shows flattening of the nasolabial folds. In which of the following labeled areas (see image) is the lesion most likely located? A. A B. B C. C D. D E. E
A. Emissary Rationale: Correct Answer: AThe emissary veins connect the extracranial venous system with the intracranial venous sinuses. They connect the veins outside the cranium to the venous sinuses inside the cranium. They drain from the scalp, through the skull, into the larger meningeal veins and dural venous sinuses exactly the superior sagittal sinus. Incorrect Answer:The diploic veins are large, thin-walled valveless veins that channel in the diploë between the inner and outer layers of the cortical bone in the skull.The basilar artery supplies the brain stem mainly the pons.
A 41-year-old with a close-cropped hairstyle routinely cuts his own hair at home. On one such occasion he sustains a deep cut to the scalp. An infection occurred at the site of the cut which he self-managed and eventually the infection seemingly subsided. Twenty days later, he woke up with a severe headache and nausea. His boyfriend brought him to the emergency department where the on-call resident diagnosed an infection of the superior sagittal sinus. Which of the following veins was most likely responsible for the patient's current infection? A. Emissary B. Inferior sagittal C. Diploic D. Basilar E. Intercavernous
A. Hypoglossal nerve and hypoglossal canal Rationale: You should immediately think of CN XII if your tongue is affected. The C1 ventral ramus joins CN XII as it travels inferolaterally into the carotid sheath space. Because the laryngeal muscles are not affected, CN X involvement can be ruled out as a possibility.
A 43-year-old patient come to the physician because the tongue deviates toward the right side, after endarterectomy procedure. Physical examination shows the sensory innervation of the head and neck soft tissues, as well as the laryngeal muscles, appears unaffected. Which of the following structures is most likely damaged by endarterectomy procedure? A. Hypoglossal nerve and hypoglossal canal B. Mandibular nerve and foramen ovale C. Facial nerve and internal acoustic meatus D. Glossopharyngeal nerve and jugular foramen E. Facial nerve and stylomastoid foramen
D. Right side facial paralysis Rationale: The parotid salivary gland is where approximately 80% of salivary gland tumors begin. The stylomastoid foramen is where the facial nerve exits. This nerve then splits into 5 to 7 major branches that control facial expression muscles. While passing through the substance of the parotid salivary gland, the branches split into temporal, zygomatic, buccal, mandibular, and cervical. While all of these branches are unlikely to be cut during the removal of the parotid tumor, they are all at risk.
A 65-year-old man comes to the physician because of a small lump on the right side of face, anterior to his right ear. At first the physician thought it might be just an enlarged lymph node. Physical examination shows no sign of infection around ear and scalp area, but the small lump is superficial to the parotid salivary gland, anterior to the external ear and posterior to the masseter muscle. Diagnosis of parotid gland cancer is made. Which of the following is the most likely risk of surgical removal of tumor? A.Loss of taste on the right side of tongue B. Loss of chewing on the right side C. Tongue deviating to the right side on protrusion D. Right side facial paralysis
B. CN VII Rationale: CN III would give a total ptosis; CN VII will lead to orbicularis oculi affected and inability to close the eye; Mandibular nerve has no relation with the eye muscles andCN II is special sense nerve. Sympathetic chain in the neck if affected could lead to pseudoptosis.
A 67-year-old man comes to the physician because he is unable to close his right eye. Physical examination shows left eyelid is able to close without any problem. Which of the following nerve lesions most likely will lead to inability to close the eye? A. CN III B. CN VII C. CN V3 D. CN II E. Cervical Sympathetic chain
A. Cranial nerve IX Rationale: The cranial nerve that provides the afferent limb of the gag reflex is the glossopharyngeal. Cranial nerve IX provides general sensation from the posterior one-third of the tongue and palatine tonsil area. When this area is touched, the soft palate and pharynx contract in a protective manner, resulting in a gag reflex. The vagus nerve is primarily responsible for the reflex's motor aspects.
A 71-year-old man come to the physician because is having difficulty swallowing and often chokes on his food for the past 2-weeks. Physical examination shows absent gag reflex. Which of the following structures is most likely responsible to carry the afferent fibers in this reflex? A. Cranial nerve IX B. Cranial Nerve X C. Cranial Nerve V D. Cranial Nerve VII E. Cranial Nerve XII
D. Submental Rationale: Collar nodes (superficial): • occipital • mastoid (posterior auricular) • parotid (pre-auricular) • submandibular • submental afferents drain superficial structures of face, scalp, and head form a collar around the neck and efferents drain mainly to the deep cervical nodesSuperficial cervical nodes - organized into anterior group (along anterior jugular v.) and posterolateral group (along EJV) - afferent drain superficial structures of the neck - efferent drain to the deep cervical nodesSupraclavicular lymph nodes are lymph nodes found above to the clavicle, that can be felt in the supraclavicular fossa.
A 50-year-old man comes to the emergency department because of a 2-week history of a pustular, draining abscess on his lower lip. He says he punctured the middle of his lip with a rusty nail and the wound is not closing spontaneously. Physical examination shows an open abscess. Which of the following lymph nodes is most likely to be enlarged on palpation? A. Inferior deep cervical B. Occipital C. Preauricular D. Submental E. Superior deep cervical F. Supraclavicular
D. Decreased general sensation from the anterior 2/3rds of the tongue on the affected side Rationale: Correct answer: The relationship between lingual nerve and submandibular duct begins with nerve lateral to the submandibular duct, this nerve courses anteromedially by looping beneath the duct and then terminating as several medial branches. The lingual nerve carries general sensation from the anterior two thirds of the tongue. Fibers for taste sensation travel with the lingual nerve distal to its junction with the chorda tympani branch of the facial nerve.Incorrect answers: general sensation from the posterior 3rd of the tongue is carried via the glossopharyngeal nerve. Protrusion of the tongue is a function of the hypoglossal nerve. Muscles of mastication are responsible for depressing and elevating the mandible and they are supplied by motor branches of the mandibular nerve.
A 50-year-old man comes to the physician because of a 1-week history of painful salivation. Physical examination shows a stone blocking the right submandibular duct and surgery is scheduled to remove the stone. During the surgery, there is trauma to the nerve that wraps around the submandibular duct. Which of the following symptoms will most likely be present in the patient as a result of this nerve damage? A. Weakened ability to protrude the tongue B. Weakened ability to depress the mandible C. Weakened ability to elevate the mandible D. Decreased general sensation from the anterior 2/3rds of the tongue on the affected side E. Decreased general sensation from the posterior 1/3rd of the tongue on the affected side
A. Loss of consensual light reflex when a light is shone in the left eye Rationale: Optic tract carries visual information from both eyes and the pretectal area projects bilaterally to both Edinger-Westphal nuclei: Consequently, the normal pupillary response to light is consensual. That is, a light directed in one eye results in constriction of the pupils of both eyes.
A 53-year-old woman comes to the physician because she is having blurred vision. Past medical history shows controlled diabetes type II. Imaging studies shows parasympathetic (ps) fibers traveling along the right CN III are affected. Which of the following symptoms will most likely be present in this patient? A. Loss of consensual light reflex when a light is shone in the left eye B. Right upper eyelid ptosis C. Right pseudoptosis D. Constricted pupil in right eye E. Loss of the right cornea reflex
A. Weakness in clenching the jaw Rationale: The trigeminal nerve's mandibular branch (CN V-3) provides sensory innervation to the skin that covers the entire length of the mandible, the mandibular teeth and gums, the lower lip and mucosa in the mouth floor, and the mucosa of the anterior 2/3 of the tongue. It also innervates the temporalis and masseter muscles, which are part of the mastication muscles that helps in clenching the lower jaw.
A 64-year-old man comes to physician because of loss of sensation on his lower lip and jaw for the past 2-months. He underwent a jaw reconstruction surgery 2 months back. Physical examination shows injury to mandibular branch of the trigeminal nerve. Which of the following additional signs and symptoms most likely be seen in this patient? A. Weakness in clenching the jaw B. Weakness in closing his upper eyelid C. Weakness in closing his lower eyelid D. Weakness in closing his mouth
G. Left ventral posteromedial nucleus of the thalamus Rationale: Sensations from the left side of the face are processed in the right ventral posteromedial nucleus of the thalamus. By contrast, the gustatory pathway seems to bilateralize in the rostral pons en route to the ventral posteromedial nucleus of the thalamus. The absence of unilateral ageusia in this patient indicates a lesion site rostral to the rostral pons. However, the internal capsule seems to be a less likely choice, as motor function is spared.
A 71-year-old man comes to the physician because of a 6-hour history of tingling from the left side of the face. Neurological examination shows loss of pain and touch from the left side of the face. Taste sensation is bilaterally intact. Touch and pain sensations are normal bilaterally in all dermatomes of the upper and lower extremities. Muscle tone and deep tendon reflexes are normal bilaterally in upper and lower extremities. Which of the following structures is most likely damaged? A. Left lateral medulla B. Right lateral medulla C. Left medial medulla D. Right medial medulla E. Left ventral posterolateral nucleus of the thalamus F. Right ventral posterolateral nucleus of the thalamus G. Left ventral posteromedial nucleus of the thalamus H. Right ventral posteromedial nucleus of the thalamus I. Left internal capsuleJ. Right internal capsule
C. Aortic arch aneurysm Rationale: The recurrent laryngeal nerve (RLN), also known as the inferior laryngeal nerve, is a branch of the vagus nerve (CN X) which has a characteristic loop around the right subclavian artery on the right and the aortic arch on the left before returning up to achieve the tracheoesophageal groove and then the larynx. Sensory and secretomotor supply to the laryngeal mucosal structures below the level of the vocal cords and trachea. In comparison, injury to the superior laryngeal nerve, which supplies only the cricothyroid muscle, causes subtle changes in voice and is less clinically significant.
A 73-year-old man comes to the physician because of hoarseness of the voice for more than three weeks. Physical examination shows left vocal fold unable to adduct to meet the right vocal fold in the midline, on phonation. Which of the following most likely could explain this finding? A. Aneurysm of the subclavian artery B. Lesion of the superior laryngeal nerve C. Aortic arch aneurysm D. Lesion of the internal laryngeal nerve E. Metastatic hilar lymph nodes at the right lung
C. Aditus ad antrum Rationale: Correct - C Aditus ad antrum. The aditus connects the epitympanic recess of the middle ear with the mastoid antrum posteriorly. Therefore, infection can spread from the middle ear to the mastoid process. The pharyngotympanic tube connects the middle ear to the pharynx, The jugular foramen is found close to the floor of the middle ear. the oval and round windows are connections between the middle ear and the inner ear.
A 77-year-old woman comes to the physician because of a 2-day history of intense pain, fever, hearing loss and swelling behind her left ear and a 1-week history of a middle ear infection for which she was treated with antibiotics. CT shows a mastoiditis represented by the arrow in the image provided. Which of the following structures most likely provides communication for the infection to spread from the middle ear to the affected area? A. Pharyngotympanic tube B. Jugular foramen C. Aditus ad antrum D. Oval window E. Round window
D. Hypothalamus Rationale: The hypothalamus acts as a comparator and often also as a sensor and an effector in relation to homeostatic regulation of vital functions such as body temperature.
An 83-year-old woman is brought to the physician by her daughter because of a 2-day history of unusual fatigue and lethargy. Her temperature is 34.9 C (94.8 F). Physical examination shows a confused and inattentive woman. Age-related hypothermia is suspected. Which of the following structures is most likely dysfunctional? A. Thalamus B. Epithalamus C. Subthalamus D. Hypothalamus E. Amygdala F. Piriform cortex