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Neuroanatomy Exam 3 BHAVESH PATEL Neck regions and triangles Anterior cervical region (anterior triangle) • Submental triangle Area inferior to the chin Boundaries: between R & L anterior belly of digastric m. and body of hyoid Content: submental lymph nodes, small veins joining to form anterior jugular v. • Submandibular triangle Glandular area Boundaries: between anterior and posterior bellies of digastric and inferior border of mandible Content: submandibular gland, submandibular lymph nodes, hypoglossal nerve (CN XII), mylohyoid nerve, parts of facial artery and vein • Carotid triangle Vascular area Boundaries: between anterior border of SCM, superior belly of omohyoid, and posterior belly of digastric Content: common carotid artery, internal jugular vein, vagus nerve (CN X), external carotid artery, hypoglossal nerve (CN XII), branches cervical plexus, thyroid gland, larynx, and pharynx • Muscular triangle Boundaries: anterior border of SCM, superior belly of omohyoid, and median plane of neck Content: infrahyoid muscles, thyroid, and parathyroid glands Light Entering the retina would reach which of the following layers last? A) Amacrine Cell Layer B) Bipolar Cell Layer C) Layer of Rods and Cones D) Ganglion Cell Layer E) Optic Nerve fiber layer Light Entering the retina would reach which of the following layers last? A) Amacrine Cell Layer B) Bipolar Cell Layer C) Layer of Rods and Cones D) Ganglion Cell Layer E) Optic Nerve fiber layer Damage to optic Chiasm would cause loss of vision where? A) Right and left nasal visual fields B) Right temporal and left nasal visual fields C) Right nasal and left temporal visual fields D) right nasal and right temporal visual fields E) right and left temporal visual fields Damage to optic Chiasm would cause loss of vision where? A) Right and left nasal visual fields B) Right temporal and left nasal visual fields C) Right nasal and left temporal visual fields D) right nasal and right temporal visual fields E) right and left temporal visual fields Which is true for visual transduction under LIT conditions A) Na+ Enters rods causing hyperpolarization B) Na+ channels are closed causing hyperpolarization C) Na+ enters rods causing depolarization D) Light causes rhodopsion to convert retinal into CIS form, inhibiting phosphodiesterase mediated hydrolysis E) Light causes rhodopsin to convert retinal into TRANS form, activating phosphodiesterase mediated hydrolysis Which is true for visual transduction under LIT conditions A) Na+ Enters rods causing hyperpolarization B) Na+ channels are closed causing hyperpolarization C) Na+ enters rods causing depolarization D) Light causes rhodopsion to convert retinal into CIS form, inhibiting phosphodiesterase mediated hydrolysis E) Light causes rhodopsin to convert retinal into TRANS form, activating phosphodiesterase mediated hydrolysis The image below shows a visual field deficit most likely caused by which of the following? A) Damage to Right parietal lobe B) Damage to Optic Chiasm C) Damage to Right Optic Nerve D) Damage to Inferior Radiating fibers E) Damage to Superior Radiating fibers The image below shows a visual field deficit most likely caused by which of the following? A) Damage to Right parietal lobe B) Damage to Optic Chiasm C) Damage to Right Optic Nerve D) Damage to Right Inferior Radiating fibers E) Damage to Right Superior Radiating fibers Select which is true of the following A) Semicircular canals detect rotational movement based on perilymph movement causing signal cascade at Crista B) Semicircular canals detect rotational movement based on endolymph movement causing signal cascade at Macula C) Saccule detects Side to Side linear movement based on otoliths moving on horizontally oriented Macula D) Saccule detects up down linear movement based on otoliths moving on vertically oriented Crista E) Saccule detects up down linear movement based on otoliths moving on vertically oriented Macula Select which is true of the following A) Semicircular canals detect rotational movement based on perilymph movement causing signal cascade at Crista B) Semicircular canals detect rotational movement based on endolymph movement causing signal cascade at Macula C) Saccule detects Side to Side linear movement based on otoliths moving on horizontally oriented Macula D) Saccule detects up down linear movement based on otoliths moving on vertically oriented Crista E) Saccule detects up down linear movement based on otoliths moving on vertically oriented Macula Damage to which of the following would cause conductive hearing loss? A) hair cells of organ of corti B) Inferior Colliculus C) Bony Ossicles D) Cochlear nucleus E) Medial Geniculate Nuclues Damage to which of the following would cause conductive hearing loss? A) hair cells of organ of corti B) Inferior Colliculus C) Bony Ossicles D) Cochlear nucleus E) Medial Geniculate Nuclues Patient has a hearing deficit in RIGHT ear due to benign Schwannoma around CN 8. Which of the following are expected during clinical exam? A) Rinne’s test -> AC > BC in both ears B) Weber’s test -> Sound is louder in right ear C) Weber’s test -> Sound heard equally in both ears D) Rinne’s test -> BC > AC in both ears Patient has a hearing deficit in RIGHT ear due to benign Schwannoma around CN 8. Which of the following are expected during clinical exam? A) Rinne’s test -> AC > BC in both ears B) Weber’s test -> Sound is louder in right ear C) Weber’s test -> Sound heard equally in both ears D) Rinne’s test -> BC > AC in both ears When testing the pupllary light reflexes of a patient, there is a slow response of the pupils to light stimulation of the right eye. The pupils react normally to light stimulation of the left eye. This finding could be indicative of injury to the A) Left Oculomotor Nerve B) Left Optic Nerve C) Right Optic Nerve D) Right oculomotor nerve E) Right Optic and Oculomotor nerve When testing the pupllary light reflexes of a patient, there is a slow response of the pupils to light stimulation of the right eye. The pupils react normally to light stimulation of the left eye. This finding could be indicative of injury to the A) Left Oculomotor Nerve B) Left Optic Nerve C) Right Optic Nerve D) Right oculomotor nerve E) Right Optic and Oculomotor nerve Damage to which of the following would lead to the MOST severe hearing deficit? A) Right Inferior colliculus B) Left Lateral lemniscus C) Right Medial geniculate nucleus D) Left Cochlear nucleus E) Right Primary auditory cortex Damage to which of the following would lead to the MOST severe hearing deficit? A) Right Inferior colliculus B) Left Lateral lemniscus C) Right Medial geniculate nucleus D) Left Cochlear nucleus E) Right Primary auditory cortex Application of the cold caloric water test to the right ear of a patient with a normal vestibular system would lead to a A) Sensation of turning to the right B) Horizontal nystagmus with the fast component to the right C) Right horizontal nystagmus D) Horizontal nystagmus with the slow component to the right E) Vertigo Application of the cold caloric water test to the right ear of a patient with a normal vestibular system would lead to a A) Sensation of turning to the right B) Horizontal nystagmus with the fast component to the right C) Right horizontal nystagmus D) Horizontal nystagmus with the slow component to the right E) Vertigo The face is supplied by which artery? A) Facial Artery of ECA B) Ophthalmic Artery of ICA C) Maxillary artery of ECA D) All of the above The face is supplied by which artery? A) Facial Artery of ECA B) Ophthalmic Artery of ICA C) Maxillary artery of ECA D) All of the above Damage to CN 7 at the stylomastoid foramen leads to which of the following? A) Disturbance in taste and salivation B) Disturbance to Muscle function Only C) Disturbance to muscle function, lacrimation, taste, and salivation D) Disturbance in balance, taste, lacrimation, salivation, hearing E) Disturbance to muscle function, taste, and salivation Damage to CN 7 at the stylomastoid foramen leads to which of the following? A) Disturbance in taste and salivation B) Disturbance to Muscle function Only C) Disturbance to muscle function, lacrimation, taste, and salivation D) Disturbance in balance, taste, lacrimation, salivation, hearing E) Disturbance to muscle function, taste, and salivation A Dysfunctional buccinators muscle will cause which issue? A) Sneer to the unaffected side B) Inability to keep food in mouth C) Inability to keep food between teeth D) Inability to pout lips E) Inability to keep food in vestibule A Dysfunctional buccinators muscle will cause which issue? A) Sneer to the unaffected side B) Inability to keep food in mouth C) Inability to keep food between teeth D) Inability to pout lips E) Inability to keep food in vestibule Left sided Bell’s Palsy would occur with damage to which of the following A) Damage to Right corticobulbar fibers B) Damage to Lower portion of Right facial nucleus C) Damage to Upper portion of Left facial nucleus D) Damage to Right CN 7 E) Damage to Left CN 7 Left sided Bell’s Palsy would occur with damage to which of the following A) Damage to Right corticobulbar fibers B) Damage to Lower portion of Right facial nucleus C) Damage to Upper portion of Left facial nucleus D) Damage to Right CN 7 E) Damage to Left CN 7 Damage to chorda tympani nerve would lead to which of the following issues? A) Disturbance in sensation of Parotid gland B) Disturbance in taste of anterior 2/3 of tongue C) Disturbance in taste of posterior 2/3 of tongue D) Disturbance in tongue movements E) Disturbance in larimation Damage to chorda tympani nerve would lead to which of the following issues? A) Disturbance in sensation of Parotid gland B) Disturbance in taste of anterior 2/3 of tongue C) Disturbance in taste of posterior 2/3 of tongue D) Disturbance in tongue movements E) Disturbance in larimation Muscles of facial expression derive from which pharyngeal arch? A) 1st Arch B) 2nd Arch C) 3rd Arch D) 4th Arch E) 5th Arch Muscles of facial expression derive from which pharyngeal arch? A) 1st Arch B) 2nd Arch C) 3rd Arch D) 4th Arch E) 5th Arch Which statement accurately describes grinding movement of the mandible A) Resting condyle pivots while Swinging condyle glides B) Resting condyle glides while swinging condyle pivots C) Resting condyle pivots while swinging condyle grinds D) Both resting and swinging condyles glide E) Both resting and swinging condyles pivot Which statement accurately describes grinding movement of the mandible A) Resting condyle pivots while swinging condyle glides B) Resting condyle glides while swinging condyle pivots C) Resting condyle pivots while swinging condyle grinds D) Both resting and swinging condyles glide E) Both resting and swinging condyles pivot The Ophthalmic nerve of enters ______ and provides sensory innervation to _____ A) Foramen rotundum; upper lips and cheeks B) Foramen rotundum; tip of nose and forhead C) Superior Orbital fissure; tip of nose and forehead D) Superior Orbital fissure; side of nose and forehead E) Superior Orbital fissure; upper lips and cheeks The Ophthalmic nerve of enters ______ and provides sensory innervation to _____ A) Foramen rotundum; upper lips and cheeks B) Foramen rotundum; tip of nose and forhead C) Superior Orbital fissure; tip of nose and forehead D) Superior Orbital fissure; side of nose and forehead E) Superior Orbital fissure; upper lips and cheeks Which of the following provides most of the blood flow to the muscles of mastication A) Pterygoid branch of Maxillary artery B) Mandibular branch of Maxillary artery C) Pterygopalatine branch of Maxillary artery D) Facial artery E) Superficial temporal artery Which of the following provides most of the blood flow to the muscles of mastication A) Pterygoid branch of Maxillary artery B) Mandibular branch of Maxillary artery C) Pterygopalatine branch of Maxillary artery D) Facial artery E) Superficial temporal artery The lingual nerve does which of the following actions? A) Carries taste information for anterior 2/3 of tongue B) Carries taste information for posterior 1/3 of tongue C) Carries sensory information for anterior 2/3 of tongue D) Carries sensory information for posterior 1/3 of tongue E) Participates in gag reflex The lingual nerve does which of the following actions? A) Carries taste information for anterior 2/3 of tongue B) Carries taste information for posterior 1/3 of tongue C) Carries sensory information for anterior 2/3 of tongue D) Carries sensory information for posterior 1/3 of tongue E) Participates in gag reflex A and C are correct. Lingual carries sensory information for CN 5. Lingual carries taste information for the chorda tympani nerve of CN 7. Which of these muscles does NOT originate from Common Tendinous ring? A) Superior Oblique B) Inferior Oblique C) Superior Rectus D) Inferior Rectus E) Medial Rectus Which of these muscles does NOT originate from Common Tendinous ring? A) Superior Oblique B) Inferior Oblique C) Superior Rectus D) Inferior Rectus E) Medial Rectus Clinically, the Inferior Rectus muscle will do which of the following? A) Adduct and depression B) Abduct and depression C) Abduct and elevation D) Adduct and elevation E) Adduction Clinically, the Inferior Rectus muscle will do which of the following? A) Adduct and depression B) Abduct and depression C) Abduct and elevation D) Adduct and elevation E) Adduction Anatomically, the Inferior Rectus muscle will do which of the following? A) Adduct and Laterally rotate (Extorsion) B) Abduct and Laterally rotate (Extorsion) C) Abduct and Medially rotate (Intorsion) D) Adduct and Medially rotate (Intorsion) E) Abduction Anatomically, the Inferior Rectus muscle will do which of the following? A) Adduct and Laterally rotate (Extorsion) B) Abduct and Laterally rotate (Extorsion) C) Abduct and Medially rotate (Intorsion) D) Adduct and Medially rotate (Intorsion) E) Abduction Damage to the long ciliary nerve would cause what issues? A) Inability to close eyelid B) Inability to open eyelid C) Loss of sensory from ciliary bodies D) Miosis E) Midriasis Damage to the long ciliary nerve would cause what issues? A) Inability to close eyelid B) Inability to open eyelid C) Loss of sensory from ciliary bodies D) Miosis E) Midriasis Lacrimation reflex requires sensory input from what nerve? CN V1 CN V2 CN 3 CN 7 CN 9 Lacrimation reflex requires sensory input from what nerve? CN V1 CN V2 CN 3 CN 7 CN 9 Optic sulci form in _____ approximately on _____ A) Optic Vesicles; Day 21 B) Optic Vesicles; Day 22 C) Eye fields; Day 22 D) Eye fields; Day 21 E) Eye fields; Day 20 Optic sulci form in _____ approximately on _____ A) Optic Vesicles; Day 21 B) Optic Vesicles; Day 22 C) Eye fields; Day 22 D) Eye fields; Day 21 E) Eye fields; Day 20 Defect in PAX6 causes which defect A) Congenital Aniridia B) Horner’s syndrome C) Persistent Iridopupillary Membrane D) Persistent Hyaloid artery E) Coloboma Defect in PAX6 causes which defect A) Congenital Aniridia B) Horner’s syndrome C) Persistent Iridopupillary Membrane D) Persistent Hyaloid artery E) Coloboma The sphincter and dilator pupillae muscles originate from which embryological tissue? A) Surface Ectoderm B) Mesenchyme C) Endoderm D) Somites E) Somitomeres The sphincter and dilator pupillae muscles originate from which embryological tissue? A) Surface Ectoderm B) Mesenchyme C) Endoderm D) Somites E) Somitomeres The internal portion of tympanic membrane is innervated by which nerve? A) CN V3 B) C2 C) CN 7 D) CN 9 E) CN 10 The internal portion of tympanic membrane is innervated by which nerve? A) CN V3 B) C2 C) CN 7 D) CN 9 E) CN 10 Blood accumulation between perichondrium and cartilage of the ear will lead to which of the following? A) Lack of Pars Tensa when viewing tympanic membrane through otoscope B) Auricular Hematoma C) Otitis Media D) Mastoiditis E) Sensorineural hearing loss Blood accumulation between perichondrium and cartilage of the ear will lead to which of the following? A) Lack of Pars Tensa when viewing tympanic membrane through otoscope B) Auricular Hematoma C) Otitis Media D) Mastoiditis E) Sensorineural hearing loss The Cupula of the Cochlea is oriented in which position? A) Anterior and Medial B) Anterior and Lateral C) Posterior and Lateral D) Posterior and Medial E) Lateral The Cupula of the Cochlea is oriented in which position? A) Anterior and Medial B) Anterior and Lateral C) Posterior and Lateral D) Posterior and Medial E) Lateral Which nerve would you expect to be active if someone yells in your ear? A) Auriculotemporal Nerve (CN V3) B) C2 C) Auricular branch of vagus nerve (CN 10) D) Glossopharyngeal Nerve (CN 9) E) Nerve to stapedius (CN 7) Which nerve would you expect to be active if someone yells in your ear? A) Auriculotemporal Nerve (CN V3) B) C2 C) Auricular branch of vagus nerve (CN 10) D) Glossopharyngeal Nerve (CN 9) E) Nerve to stapedius (CN 7) Presynaptic fibers for the otic ganglion must travel through which of the following? A) Tegmental Wall B) Labyrinthine wall C) Carotid Wall D) Jugular Wall E) Mastoid Wall Presynaptic fibers for the otic ganglion must travel through which of the following? A) Tegmental Wall B) Labyrinthine wall C) Carotid Wall D) Jugular Wall E) Mastoid Wall _______ forms the geniculate ganglion and makes a sharp turn _____ within the middle ear. A) CN 7; Laterally B) CN 7; Posteriorly C) CN 7; Medially D) CN 7; Anteriorly _______ forms the geniculate ganglion and makes a sharp turn _____ within the middle ear. A) CN 7; Laterally B) CN 7; Posteriorly C) CN 7; Medially D) CN 7; Anteriorly Cricothyroid originates from which pharyngeal arch A) 1st arch B) 2nd arch C) 3rd arch D) 4th arch E) 6th arch Cricothyroid originates from which pharyngeal arch A) 1st arch B) 2nd arch C) 3rd arch D) 4th arch E) 6th arch External auditory meatus originates from which pharyngeal arch? A) 1st arch B) 2nd arch C) 3rd arch D) 4th arch E) 6th arch External auditory meatus originates from which pharyngeal arch? A) 1st arch B) 2nd arch C) 3rd arch D) 4th arch E) 6th arch NONE -> originates from 1st pharyngeal CLEFT Recurrent Laryngeal Nerve originates from which pharyngeal arch? A) 1st arch B) 2nd arch C) 3rd arch D) 4th arch E) 6th arch Recurrent Laryngeal Nerve originates from which pharyngeal arch? A) 1st arch B) 2nd arch C) 3rd arch D) 4th arch E) 6th arch Sensory information for anterior 2/3 of the tongue originates from which pharyngeal arch? A) 1st arch B) 2nd arch C) 3rd arch D) 4th arch E) 6th arch Sensory information for anterior 2/3 of the tongue originates from which pharyngeal arch? A) 1st arch B) 2nd arch C) 3rd arch D) 4th arch E) 6th arch Parotid gland forms from which of the following? A) Ectoderm of maxillary/mandibular swellings B) Endoderm of maxillary/mandibular swellings C) Ectoderm of oral cavity floor D) Endoderm of oral cavity floor E) Ectoderm of paralingual sulci Parotid gland forms from which of the following? A) Ectoderm of maxillary/mandibular swellings B) Endoderm of maxillary/mandibular swellings C) Ectoderm of oral cavity floor D) Endoderm of oral cavity floor E) Ectoderm of paralingual sulci The superior parathyroid gland originates from which of the following? 3rd pharyngeal arch 3rd pharyngeal pouch 3rd pharyngeal cleft 4th pharyngeal arch 4th pharyngeal pouch The superior parathyroid gland originates from which of the following? 3rd pharyngeal arch 3rd pharyngeal pouch 3rd pharyngeal cleft 4th pharyngeal arch 4th pharyngeal pouch A 5 day old infant was born with a normal apgar score but one month later the external auditory meatus was atretic. Which of the follow conditions was the most likely cause if this defect? A. Otic pit didn’t form B. Development of the 1st pharyngeal pouch was affected C. Meatal plug did not canalize D. Auricular hillocks did not development E. The tubotympanic recess degenerated A 5 day old infant was born with a normal apgar score but one month later the external auditory meatus was atretic. Which of the follow conditions was the most likely cause if this defect? A. Otic pit didn’t form B. Development of the 1st pharyngeal pouch was affected C. Meatal plug did not canalize D. Auricular hillocks did not development E. The tubotympanic recess degenerated A. B. a 63 y/o man with hearing loss in his left ear complains of a loss of taste and drooling from the left side of his mouth. A CT scan shows a tumor compressing the nerve entering the skull through which opening? Foramen ovale foramen rotundum C. Internal acoustic meatus D. Jugular foramen E. Superior orbital fissure A 63 y/o man with hearing loss in his left ear complains of a loss of taste and drooling from the left side of his mouth. A CT scan shows a tumor compressing the nerve entering the skull through which opening? A. Foramen ovale B. Foramen rotundum C. Internal acoustic meatus D. Jugular foramen E. Superior orbital fissure A 34 y/o swimmer presents to your office with an external ear canal infection (otitis externa). The patient coughs during inspection of the external auditory meatus. The cough results from irritation of which nerve? A. Vestibulocochlear B. Vagus C. Trigeminal D. Facial E. accessory A 34 y/o swimmer presents to your office with an external ear canal infection (otitis externa). The patient coughs during inspection of the external auditory meatus. The cough results from irritation of which nerve? A. Vestibulocochlear B. Vagus C. Trigeminal D. Facial E. accessory How many cranial nerves are in the middle fossa? A) 1 B) 3 C) 5 D) 6 How many cranial nerves are in the middle fossa? A) 1 B) 3 C) 5 D) 6 In infants, you pull the ear _______ when trying to look into the ear. A) Up and back B) Down and back C) Up and forwards D) Down and forward E) You don’t pull In infants, you pull the ear _______ when trying to look into the ear. A) Up and back B) Down and back C) Up and forwards D) Down and forward E) You don’t pull Which of the following is derived from cartilaginous precursors? A) Neurocranium B) Calvarium C) Viscerocranium D) Posterior fossa Which of the following is derived from cartilaginous precursors? A) Neurocranium B) Calvarium C) Viscerocranium D) Posterior fossa The only place in head where ECA and ICA blood supply overlap is A) Orbit B) Nose C) Ear D) All of the above E) None of the above The only place in head where ECA and ICA blood supply overlap is A) Orbit B) Nose C) Ear D) All of the above E) None of the above
