Download Anatomy - head and neck

Anatomy - head and neck - 2007
1. During a soccer game, a forward player got a gore to his head, and was hit at
the zygomatic arch. Upon examination, a fracture at the zygomatic arch was
found. What is correct?
a. The repair must include mainly the zygomatic arch
b. The repair must include both the zygomatic and the temporal bones
c. One of the side effects of such a fracture is difficulty in opening the
mouth
d. One of the common side effects of such a fracture is lack of sensation
at the infra-orbital area
e. b + c are correct
2. The forward went to the hospital for repair of the fracture. What is correct?
a. The surgeon would make a cut at the temporal area to the depth of
deep temporal fascia, and slide along (above the fascia) to the arch
b. The surgeon would make a cut at the temporal area to the depth of the
temporalis muscle, and slide along the muscle to the arch
c. The surgeon would make a cut at the temporal area to the depth of
superficial temporal fascia, and slide along (above the fascia) to the
arch
d. The surgeon would make a cut at the temporal area to the depth of
subcutaneous tissue, and slide along (above the subcutaneous tissue) to
the arch
3. At the second half of the game the defender receives a blow to the face area.
At the replay it seems that the blow was directed to the nose, which later
caused a severe bleeding from the nose. What is correct?
a. The nose is a very vascular organ, receiving its blood supply from the
external carotid artery
b. The nose is a very vascular organ, receiving its blood supply from the
internal carotid artery
c. Kiesselbach plexus is the main source of the bleeding
d. The sphenopalatine artery contributes to the bleeding
e. All of the above are correct
4. At the same game, the goaltender got a strong blow to the lower jaw. At the
examination, a fracture of the mandible was diagnosed. At the X-ray imaging
the fracture was demonstrated distal to the mental foramen. What would be the
complaint of the goaltender?
a. Lack of sensation at the upper lip
b. Lack of sensation at the lower lip, at the injured side
c. Lack of sensation at the lower lip, at the contra lateral side
d. Lack of sensation at the tongue
e. Difficulty in moving the lips
f. None of the above
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5. Which of the following is the continuation of the galea to the temporal region?
a. Deep temporal fascia
b. Superficial temporal fascia
c. SMAS
d. None of the above
6. Horner's syndrome is caused by damage to the sympathetic nervous system.
What is correct?
a. Dilated pupil
b. Partial fall (ptosis) of the eyelid (the involuntary part)
c. Dry skin
d. All of the above
e. a + b
f. b + c
7. A patient was diagnosed with oropharyngeal malignancy and is scheduled for
neck surgery (areas 1-5), including posterior triangle. What is probable
following the surgery?
a. Difficulty rising the shoulder
b. Lack of sensation at the ear lobe
c. Difficulty moving the angle of the mouth
d. Lack of sensation at the lower lip
e. a + b
f. a + b + c
g. None of the above
8. During thyroidectomy, while dissecting the lower edge of the gland, an arterial
bleeding has erupted. What is the most probable source of the bleeding?
a. Thyroid middle artery
b. Ima thyroid artery, which originates from the thyrocervical trunk
c. Ima thyroid artery, which originates from the brachiocephalic trunk
d. Inferior thyroid, which originates from the aortic arch
e. Inferior thyroid, which originates from the external carotid artery
f. a + b
g. b + d
h. c + e
i. a + e
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9. During general anesthesia a tubus (tracheal tube) is inserted. What is correct?
a. In an adult, the diameter of the tubus is chosen according to the space
between the vocal cords, which is the narrowest point at the larynx
b. In an adult, the diameter of the tubus is chosen according to the
diameter of the first tracheal ring, which is the narrowest point at the
larynx
c. In a child, the diameter of the tubus is chosen according to the diameter
of the cricoid, which is the narrowest point at the larynx
d. In a child, the diameter of the tubus is chosen according to the diameter
of the first tracheal ring, which is the narrowest point at the larynx
e. a + c
f. b + c
g. c + d
h. b + d
10. For prevention of aspiration (passage of liquids etc. from the esophagus to the
larynx), what is correct to do?
a. Press the first tracheal ring (which is all made of cartilage) towards the
esophagus, thus obstructing the passage
b. Press the cricoid (which is all made of cartilage) towards the
esophagus, thus obstructing the passage
c. Press the thyroid cartilage (which is all made of cartilage) towards the
esophagus, thus obstructing the passage
d. There is no need to prevent aspiration
e. None of the above is correct
11. During a neck surgery at the parotid triangle area, the anesthesiologist has
remarked that the patient has developed arrhythmia. What is the probable
reason?
a. The vagus nerve passes through the parotid triangle area, and it has
caused slowing of the heart rate
b. The glossopharyngeal nerve passes through the parotid triangle area,
and it has caused acceleration of the heart rate
c. The ansa cervicalis passes through the parotid triangle area, and it has
caused acceleration of the heart rate
d. The vagus nerve passes through the parotid triangle area, and it has
caused acceleration of the heart rate
e. a + c
f. b + d
g. None of the above
12. During parathyroidectomy (removing of a parathyroid gland), it is most
important to avoid injuring the:
a. Recurrent laryngeal nerve
b. Internal laryngeal nerve
c. Hypoglossal nerve
d. Lingual nerve
e. None of the above
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13. During larynx surgery, the surgeon has cut the superior laryngeal artery. Which
artery should he tie?
a. Inferior thyroid artery
b. Superior thyroid artery
c. Thyroid ima artery
d. Ascending pharyngeal artery
e. Ascending palatine artery
f. None of the above
14. Following tying the artery of the previous question, the bleeding continues.
Which artery should he tie now?
a. Facial artery
b. Superior thyroid artery
c. External carotid artery
d. Ascending pharyngeal artery
e. Descending palatine artery
f. None of the above
15. During a surgery, the surgeon has cut the deep cervical artery. Which artery
should he tie?
a. Vertebral artery
b. Costocervical trunk
c. Thyrocervical trunk
d. Dorsal scapular
e. Any of the above
16. During thyroidectomy (thyroid gland excision) the surgeon has cut the superior
laryngeal nerve. The injury will cause:
a. Lack of sensation of the mucosa at the supraglottic region
b. Lack of sensation of the mucosa at the infraglottic region
c. Hoarseness
d. Breathing difficulties
e. a + b
f. b + c
g. a + c
h. All of the above
17. Which structure will not be damaged from fracture of the left clavicle lateral to
the scalenes?
a. Left brachial plexus
b. Left subclavian vein
c. Left subclavian artery
d. The dome of the pleura
e. Left phrenic nerve
f. a + b
g. b + c
h. d + e
i. All of the above
18. During a fight, one of the involved was injured at his head, which caused
bleeding that was difficult to stop. What is correct?
a. Blood supply to the scalp is double - from the ICA and the ECA
b. The blood vessels are located in the third layer
c. The bleeding is massive due to the dense connective tissue, in which the
vessels are located
d. a + b
e. a + c
f. a + b + c
19. The deep temporal fascia covers the temporal muscle. What is correct?
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a. It is continuous with the pericranium of the scalp
b. At the area of the zygomatic arch the fascia splits to wrap the arch from
above and below
c. The temporal nerve (part of the VII cranial nerve) runs inside the fascia
d. a + b
e. a + b + c
20. Following a neck surgery, the patient experienced hoarseness on the following
day (decrease in the intensity of the voice). The probable nerve to be injured:
a. Internal laryngeal
b. External laryngeal
c. Recurrent laryngeal
d. The patient is probably cold
e. None of the above
21. One of the important structures that is met during tracheostomy (opening of the
trachea) is:
a. Parathyroid gland
b. Thyroid gland
c. Hyoid bone
d. Epiglottis
e. None of the above
22. The equator is:
a. A plane related to the orbit and the eyeball
b. The superior oblique passes behind it
c. The inferior oblique passes in front of it
d. a + b
e. a + c
f. All of the above are correct
23. Which structure is located at the level of C6?
a. Laryngeal prominence
b. The hyoid bone
c. The hard palate
d. Cricoid cartilage
e. Common carotid bifurcation
24. Which of the tongue papillae is located along the terminal sulcus?
a. Vallate papillae
b. Foliate papillae
c. Filiform papillae
d. Fungiform papillae
e. a + b
f. b + c
g. c + d
h. None of the above
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25. Which of the following does not drain into the middle meatus of the nose?
a. Maxillary sinus
b. Ethmoidal sinus
c. Sphenoid sinus
d. Nasolacrimal duct
e. Frontal sinus
f. a + c
g. c + d
h. b + c + d
i. All of the above drain into the middle meatus
26. The first vertebra that can be palpated at the back of the neck is:
a. C5
b. C6
c. C7
d. T1
e. T2
27. What is incorrect?
a. All of the palatine muscles attach (origin or insertion) to the palatine
aponeurosis
b. The palatine muscles construct the soft palate
c. All the palatine muscles get motor innervation from the vagus nerve
d. The palatine muscles' action is essential for pressure equilibration
between the pharynx and the middle ear via the Eustachian tube
e. a + b
f. c + d
g. a + c + d
h. All of the above are correct
28. What is incorrect regarding the tonsils?
a. The pharyngeal tonsil is located in the nasopharynx
b. The lingual tonsil is located in the medial part of the tongue
c. Enlarged pharyngeal tonsil can obstruct the nasopharynx
d. The pharyngeal, palatine and lingual tonsils together create the
lymphatic ring of the pharynx
e. No correct answer
29. During cataract surgery, we preserve the:
a. Nucleus
b. Capsule and zonules
c. Cortex
d. Only the anterior capsule
30. The vestibular organ is:
a. Responsible for the sensation of linear and angular acceleration
b. Part of the structure of the middle ear
c. Injury to one of the vestibular organs will not cause dizziness, as it is
possible to "get along" with only one
d. Part of the temporal bone and is located anterior to the cochlea
e. a + b
f. b + c
g. a + d
h. No correct answer
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31. In young children, infectious process in the middle ear can spread to:
a. The anterior cranial fossa
b. Middle cranial fossa
c. Due to the bony boundary, there is no spread
d. Sella turcica
e. a + b
f. b + c
g. a + d
h. None of the above is correct
32. The nerve point is the point of meeting of:
a. Lesser occipital
b. Greater occipital
c. Greater petrosal
d. Greater auricular
e. Transverse cervical
f. Supraclavicular nerve
g. a + b + c
h. b + c + d
i. a + d + e + f
33. A surgery was performed to excise a tumor (space occupying lesion) from the
pterygopalatine fossa area. What can be the consequence?
a. Loss of sensation at the forehead on the operated side
b. Loss of sensation at the cheek area on the operated side
c. Decrease or lack of tears on the operated side
d. Decrease or partial lack of saliva production on the operated side
e. a + b
f. a + c
g. b + c
h. b + c + d
i. All of the above
34. The most important part of the retina for acuity of vision is:
a. The center
b. The perimeter of the macula lutea
c. The optic nerve
d. The temporal retina
35. The cornea comprises 5 layers, and can become edematous due to failure of:
a. The stroma
b. The epithelium
c. The stroma and the epithelium
d. The endothelium
e. b + d
f. All of the above
36. When inspecting a healthy tympanic membrane with an otoscope, which of the
ossicles would usually be clearly seen?
a. Stapes
b. Incus
c. Head of the malleolus
d. The long arm of the malleolus
e. a + b
f. b + c
g. b + c + d
h. All of the above
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37. In a patient with peripheral facial nerve (cranial nerve number 7) palsy on the
right side, which defense mechanism of the ipsilateral ear would not work
while the patient is exposed to loud noise?
a. Tensor tympani muscle
b. Stapedius muscle
c. Eustachian tube
d. Sternocleidomastoid muscle
e. a + b
f. b + c
g. b + d
h. None of the above
In questions 38-43, match between the structure and its route of passage:
38.
39.
40.
41.
42.
43.
Glossopharyngeal nerve
Accessory nerve
Internal carotid artery
Maxillary nerve
Facial nerve
Middle meningeal artery
a.
b.
c.
d.
e.
f.
g.
Foramen ovale
Foramen spinosum
Foramen rotundum
Jugular foramen
Optic foramen
Internal acoustic meatus
None of the above
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Possible answers:
1. e
2. b
3. e
4. f
5. b
6. f
7. f
8. c
9. e
10. b
11. a
12. a
13. b
14. c
15. b
16. g
17. i
18. e
19. d
20. b
21. b
22. e
23. d
24. a
25.
26.
27.
28.
29.
30.
31.
32.
33.
34. a
35. d
36. d
37. b
38. d
39. d
40. g
41. c
42. f
43. b
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