Download Head and neck

Head
and
neck
1. Damage to the external laryngeal nerve
in the inability to
(A) Relax the vocal cords
(B) Rotate the arytenoid cartilages
(C) Tense the vocal cords
(D) Widen the rima glottidis
(E) Abduct the vocal cords
during thyroid surgery could result
2. On ligation of the superior laryngeal artery ,care must be taken to avoid injury
to which of the following nerves?
(A) External laryngeal nerve
(B) Internal laryngeal nerve
(C) Superior laryngeal nerve
(D) Hypoglossal nerve
(E) Vagus nerve
3. In a patient who demonstrates a lack of general sensation in the nasopharynx
,a lesion of which of following nerves would be expected?
(A)Maxillary nerve
(B)Superior cervical ganglion
(C)External laryngeal nerve
(D)Glossopharyngeal nerve
(E)Vagus nerve
4. During surgery ,a surgeon notices profuse bleeding from the deep cervical
artery,which of the following arteries must be ligated immediately?
(A)Inferior thyroid artery
(B)Transverse cervical artery
(C)Thyrocervical trunk
(D)Costocervical trunk
(E)Ascending cervical artery
5. The phrenic nerve passes
(A)
(B)
(C)
(D)
(E)
by which of the following structures in the neck?
Anterior to the subclavian vein
Posterior to the subclavian artery
Deep to the anterior scalene muscle
Medial to the common carotid artery
Superficial to the anterior scalene muscle
6. Which of the following muscles is a landmark for locating the glossopharyngeal
Nerve in the neck?
(A)Inferior
pharyngeal
constrictor
muscle
(B)Stylopharyngeus muscle
(C)Posterior belly of the
(D)Longus colli muscle
(E)Rectus capitis anterior
digastric
muscle
muscle
7.A lesion of the external laryngeal branch of the superior laryngeal nerve
may cause weakness of which of following muscles?
(A)Inferior pharyngeal constrictor muscle
(B)Middle pharyngeal constrictor muscle
(C)Superior pharyngeal constrictor muscle
(D)Thyroarytenoid muscle
(E)Thyrohyoid muscle
8.A patient with crocodile tears syndrome has spontaneous lacrimation during
due to misdirection of regenerating autonomic nerve fibers .which of the
following nerves has been injured?
(A)Facial nerve proximal to the geniculate ganglion
(B)Auriculotemporal nerve
(C)Chorda tympani in the infratemporal fossa
(D)Facial nerve at the stylomastoid foramen
(E)Lacrimal nerve
9.A 13-year-old girl complains of dryness of the nose and the palate,indicating
a lesion of which of the following ganglia?
(A)Nodose ganglia
(B)otic ganglia
(C)Pterygopalating ganglia
(D)submandibular ganglia
(E)Ciliary ganglia
10.Bell’spalsy can involve
corneal inflammation and subsequent corneal
ulceration ,which results from
(A) sensory loss of the cornea and conjunctiva
(B) lack of secretion of the salivary glands
(C) absence of the corneal blink reflex due to paralysis of the muscles
close the eyelid
(D) absence of the corneal blink reflex due to paralysis of the muscles
open the eyelid
(E) constriction of the pupil due to paralysis of the dilator pupillae
that
that
11.which of the following sinuses lies in the margin of the tentorium
cerebelli,running from the posterior end of the cavernous sinus to the transverse
sinus?
(A)
(B)
(C)
(D)
(E)
Straight sinuses
Inferior sagittal sinuses
Sphenoparietal sinuses
Superior petrosal sinuses
Cavernous sinuses
12.Which of the following condition results from severance of the abducens nerve
Proximal to its entrance into the orbit?
(A)
(B)
(C)
(D)
(E)
Ptosis of the upper eyelid
Loss of the ability to dilate the pupil
External strabismus (lateral deviation)
Loss of visual accommodation
Internal strabismus (medial deviation)
13.Death may result from bilateral severance of which of the following nerves?
(A)
(B)
(C)
(D)
(E)
trigeminal nerve
Facial nerve
Vagus nerve
Spinal accessory nerve
Hypoglossal nerve
14.When the middle meningeal artery is
enters which of the following spaces?
(A)
(B)
(C)
(D)
(E)
ruptured but the meninges intagt.blood
Subarachnoid space
Subdural space
Epidural space
Subpial space
Cranial dural sinuses
15.which of the following structures contains cell bodies of preganglionic
parasympathetic neurons?
(A)
(B)
(C)
(D)
(E)
Cervical and sacral spinal cord
Cervical and thoracic spinal cord
Brainstem and cervical spinal cord
Thoracic and lumbar spinal cord
Brainstem and sacral spinal cord
16.Following radical resection of a primary tongue tumor,a patient has lost general
sensation on the anterior two-thirds of the tongue ,which of the following nerves?
(A)
(B)
(C)
(D)
(E)
trigeminal nerve
Facial nerve
Glossopharyngeal nerve
Vagus nerve
Hypoglossal nerve
17.The pituitary gland lies in the sella tureica immediately posterior and superior
to which of the following structures?
(A)
(B)
(C)
(D)
(E)
Frontal sinus
Maxillary sinus
Ethmoid air cells
Mastoid air cells
Sphenoid sinus
18.After tonsillectomy ,a-year-boy is unable to distinguish the sensation of taste
on the posterior one-third of his tongue.Which of the following nerves most likely
has been injured?
(A)
(B)
(C)
(D)
(E)
Internal laryngeal nerve
Lingual nerve
Lingual branch of the glossopharyngeal nerve
Greater palatine nerve
Chorda tympani
19. Damage to the sella turcica is probably due to fracture of which of the following
bones?
(A)
(B)
(C)
(D)
(E)
frontal bone
Ethmoid bone
Temporal bone
Basioccipital bone
Sphenoid bone
20.The scalenus anterior muscle
(A)
(B)
(C)
(D)
(E)
inserts on the second rib
is innervated by the phrenic nerve
passes anterior to the subclavian vein
descends posterior to the subclavian artery
runs anterior to the root of the brachial plexus
21.A patient has an infectious inflammation of the dural venous sinus nearest to
the pituitary gland ,with secondary thrombus formation .Which of the following
is the most likely site of infection?
(A)
(B)
(C)
(D)
(E)
Straight sinus
Cavernous sinus
Superior petrosal sinus
Sigmoid sinus
Confluence of sinuses
22. A patient with a pituitary tumor would exhibit which of the following disorders?
(A)
(B)
(C)
(D)
(E)
Blindness
Bitemporal (heteronymous )hemianopia
Right nasal hemianopia
Left homonymous hemianopia
Binasal hemianopia
23.If a patient is unable to abduct the vocal cords during quiet breathing , which
of the following muscles is paralyzed?
(A)
(B)
(C)
(D)
(E)
Vocalis muscle
Cricothyroid muscle
Oblique arytenoid muscle
Posterior cricoarytenoid
Thyroarytenoid muscle
muscle
24. Which of the following pairs of muscles is most instrumental in preventing
food from entering the larynx and trachea during swallowing?
(A)
(B)
(C)
(D)
(E)
Sternohyoid and sternothyroid muscles
Oblique arytenoid and aryepiglottic muscles
Inferior pharyngeal constrictor and thyrohyoid muscles
Levator veli palatini and tensor veli palatini muscles
Musculus uvulae and geniohyoid muscles
25.The veins of the brain are direct tributaries of the
(A)
(B)
(C)
(D)
(E)
emissary veins
pterygoid venous plexus
diploic veins
dural venous sinuses
internal jugular vein
26. Which of the following conditions or actions results from stimulation of the
parasympathetic fibers to the eyeball?
(A) Enhanced vision for distant objects
(B) Dilation of the pupil
(C) Contraction of capillaries in the iris
(D) Contraction of the ciliary muscle
(E) Flattening of the lens
27.The tympanic nerve
(A)
(B)
(C)
(D)
(E)
is a branch of the facial nerve
contains postganglionic parasympathetic fibers
synapses with fibers in the lesser petrosal nerve
is a branch of the glossopharyngeal nerve
forms the tympanic plexus in the external auditory meatus
28. Which of the following cavities are separated
by a thin layer of bone?
(A)
(B)
(C)
(D)
(E)
from the middle cranial fossa
Auditory tube and bony orbit
Middle ear cavity and sphenoid sinus
Sigmoid sinus and frontal sinus
Sphenoid sinus and ethmoid sinus
Maxillary sinus and middle ear cavity
29.Loss of general sensation in the dura of the middle cranial fossa indicates
a lesion of the
(A)
(B)
(C)
(D)
(E)
vagus nerve
facial nerve
hypoglossal nerve
trigeminal nerve
glossopharyngeal nerve
30.The carotid sinus
(A)
(B)
(C)
(D)
(E)
is located at the origin of the external carotid artery
is innervated by the facial nerve
functions as a chemoreceptor
is stimulated by changes in blood pressures
communicates freely with the cavernous sinus
31.During a game ,a 26-year-old baseball player receives a severe blow to the head
that fractures the optic canal. Which of the following pairs of structures is most
likely to be damaged?
(A)
(B)
(C)
(D)
(E)
Optic nerve and ophthalmic vein
Ophthalmic vein and ophthalmic nerve
Ophthalmic artery and optic nerve
Ophthalmic nerve and optic nerve
Ophthalmic artery and ophthalmic vein
32.Paralysis of the posterior belly of the digastric muscle would result from a
lesion of which of the following nerve?
(A)
(B)
(C)
(D)
(E)
Accessory nerve
Trigeminal nerve
Ansa cervicalis
Facil nerve
Glossopharyngeal nerve
33.Contraction of the tensor tympani and the stapedius prevents damage to the
eardrum and middle ear ossicles.These muscles are most likely controlled by which
of the following nerves?
(A)
(B)
(C)
(D)
(E)
Chorda tympani and tympanic nerve
Trigeminal and facial nerve
Auditory and vagus nerve
Facial and auditory nerve
Trigeminal and Accessory nerve
34.If a patient’s pupil remains small when room lighting is subdued,which of the
following nerve would be injured?
(A)
(B)
(C)
(D)
(E)
Trochlear nerve
Superior cervical ganglion
Oculomotor nerve
Ophthalmic nerve
Abducens nerve
35. Which of the following statements concerning the frontal sinus is correct?
(A)
(B)
(C)
(D)
(E)
It extends into the parietal bone
It communicates with the superior nasal meatus
It receives sensory innervation from the maxillary nerve
It is supplied with blood by branches of the ophthalmic artery
It is a cranial dural venous sinus that receivesthe ophthalmic vein
36.A patient can move his eyeball normally and see distant objects clearly but
cannot focus on near objects .This condition may indicate damage to the
(A)
(B)
(C)
(D)
(E)
ciliary ganglion and oculomotor nerve
oculomotor nerve and long ciliary nerve
short ciliary nerve and ciliary ganglion
superior cervical ganglion and long ciliary nerve
oculomotor.trochlear ,and abducens nerve
37. Which of the following structures enters the orbit through the superior orbital
fissure and the common tendinous ring?
(A)
(B)
(C)
(D)
(E)
Frontal nerve
Lacrimal nerve
Trochlear nerve
Abducens nerve
Ophthalmic vein
38.Which of the following groups cranial nerves is damaged if the muscles attached
to the styloid process are paralyzed?
(A)
(B)
(C)
(D)
(E)
Facial ,glosssopharyngeal,and hypoglossal nerve
Hypoglossal ,vagus,and facial nerve
Glosssopharyngeal,trigeminal,and vagus nerve
Vagus ,spinal accessory ,and hypoglossal nerve
Facial . glosssopharyngeal,and vagus nerve
39.A 32-yare-old woman has hoarseness in her voice ,and her uvula is deviated to
the left upon phonation, Which of the following nerve is danaged?
(A)
(B)
(C)
(D)
(E)
Right trigeminal nerve
Left trigeminal nerve
Right vagus nerve
Left vagus nerve
Left glosssopharyngeal nerve
40.When a low tracheotomy is performed below the isthmus of the thyroid , which
of the following vessels may be encountered?
(A)
(B)
(C)
(D)
(E)
Inferior thyroid artery
Inferior thyroid vein
Costocervical trunk
Superior thyroid artery
Right brachiocephalic vein
41.If a patient has no cutaneous sensation on the anterior cervical triangle,it
is likely that damage has occurred to which of the following nerves?
(A)
(B)
(C)
(D)
(E)
Phrenic nerve
Greater auricular nerve
Transverse cervical nerve
Supraclavical nerve
Lsser occipital nerve
42.In a patient with swelling of the mucous membranes of the supperior nasal
meatus,which of the openings of the paranasal sinuses are plugged?
(A)
(B)
(C)
(D)
(E)
Middle ethmoidal sinus
Maxillary sinus
Posterior ethmoidal sinus
Anterior ethmoidal sinus
Frontal sinus
43.The tongue of a 45-year-old patient deviates to the left on protrusion.Which
of the following nerves is injured?
(A)
(B)
(C)
(D)
(E)
Right lingual nerve
Left lingual nerve
Right hypoglossal nerve
Left hypoglossal nerve
Left glosssopharyngeal nerve
44.Which condition would most likely result in a patient’s inability to move the
his right eye laterally?
(A)
(B)
(C)
(D)
(E)
A tumor of the pituitary gland
Occlusion of the right posterior cerebral artery
An infection in the right maxillary sinus
An infection in the right cavernous sinus
A tumor in the right anterior cranial fossa
45.If the lingual nerve is damaged as it enters the oral cavity ,which of the
following structures contain cell bodies of injured nerve fibers?
(A)
(B)
(C)
(D)
(E)
Geniculate
Trigeminal
Trigeminal
Geniculate
Geniculate
and
and
and
and
and
otic ganglia
submandibular ganglia
dorsal root ganglia
trigeminal ganglia
pterygopalatine ganglia
46.A tumor located in the optic canal would most likely damage which of the
following structures?
(A)
(B)
(C)
(D)
(E)
Ophthalmic
Ophthalmic
Oculomotor
Trochlear
Ophthalmic
vein
nerve
nerve
nerve
artery
47.A horizontal cut through the cricothyroid ligament in the neck would sever which
of the following structures?
(A)
(B)
(C)
(D)
(E)
Inferior laryngeal nerve
External carotid arteries
Inferior thyroid vein
Thyrocervical trunks
Internal laryngeal nerve
48.Severance of the oculomotor nerve can cause which of the following condition ?
(A)
(B)
(C)
(D)
(E)
Complete ptosis
Abduction of the eyeball
A constricted pupil
Impaired lacrimal secretion
Paralysis of the ciliary muscle
49. Which of the following nerve supply striated muscles and are of branchiomeric
origin?
(A)
(B)
(C)
(D)
(E)
Oculomotor nerves
Trochlear nerves
Trigeminal nerves
Abducens nerves
Hypoglossal nerves
50.During surgery for malignant parotid tumors,the main trunk of the facial nerve
is lacerated ,resulting in paralysis of which of the following muscles?
(A)
(B)
(C)
(D)
(E)
Masseter muscle
Stylopharyngeus muscle
Anterior belly of the digastric muscle
Buccinator muscle
Tensor tympani
51.During gang fighting ,the nasal septum of a 17-year-old boy injured by a fist ,
which of the following structures would be damaged?
(A)
(B)
(C)
(D)
(E)
Septal cartilage and nasal bone
Inferior concha and vomer
Vomer and perpendicular plate of ethmoid
Septal cartilage and middle concha
Cribriform plate and incisive foramen
52.The tensor tympani
(A) inserts on the long process of the incus
(B) is innervated by a branch of the facial nerve
(C) runs parallel to the external acoustic meatus
(D) arises chiefly from the tympanic membrane
(E) functions to tighten the tympanic membrane
53.Infection within the carotid sheath may damage which of the following
structures?
(A)
(B)
(C)
(D)
(E)
Vagus nerve and middle cervical ganglion
Common carotid artery and recurrent laryngeal nerve
Internal jugular vein and vagus nerve
Sympathetic trunk and common carotid artery
External carotid artery and ansa cervicalis
54.An occlusion of the costocervical trunk could produce a marked decrease in the
blood flow in which of the following arteries?
(A)
(B)
(C)
(D)
(E)
Superior thoracic artery
Transverse cervical artery
Ascending cervical artery
Deep cervical artery
Inferior thyroid artery
55.The internal laryngeal nerve
(A)
(B)
(C)
(D)
(E)
is a branch of the superior laryngeal nerve
may contain taste fibers from the palate
provides sensory innervation to the laryngeal mucosa below the vocal cord
provides motor innervation to the cricothyroid muscle
is accompanied by the superior thyroid artery
56. Which of the following nerve would be spared from infection in the cavernous
sinus?
(A)
(B)
(C)
(D)
(E)
Oculomotor nerves
Abducens nerves
Trochlear nerves
Mandibular nerves
Ophthalmic nerves
57. Which of the following tonsils is called the adenoid when enlarged?
(A)
(B)
(C)
(D)
(E)
Palatine tonsil
Pharyngeal tonsil
Tubal tonsil
Lingual tonsil
Eustachian tonsil
58.An eroded lesion in the jugular foramen may damage which of the following pairs
of structures?
(A)
(B)
(C)
(D)
(E)
Vagus nerve and internal carotid artery
Accessory nerve and external jugular vein
Internal jugular vein and hypoglossal nerves
Glossopharyngeal and vagus nerve
Hypoglossal and spinal accessory nerves
59.A 12-year-old girl is unable to close her lips . Which of the following muscles
is paralyzed?
(A)
(B)
(C)
(D)
(E)
Levator labii superioris
Zygomaticus minor
Orbicularis oris
Lateral pterygoid
Depressor labii superioris
60.Severance of the greater petrosal nerve would produce which of the following
conditions?
(A)
(B)
(C)
(D)
(E)
Increased lacrimal gland secretion
Loss of taste sensation in the epiglottis
Dryness in the nose and palate
Decreased parotid gland secretion
Loss of general visceral sensation in the pharynx
61.A benign tumor in the pterygoid canal could injure which of the following nerve
fibers?
(A)
(B)
(C)
(D)
(E)
Postganglionic parasympathetic fibers
Taste fiber from the epiglottis
General somatic afferent (GSA) fibers
Preganglionic sympathetic fibers
General visceral afferent(GVA) fibers
62.The pupillary light reflex can be eliminated by cutting which of the following
nerve?
(A)
(B)
(C)
(D)
(E)
Short ciliary,ophthalmic,and oculomotor nerves
Long ciliary,optic ,and short ciliary nerves
Oculomotor, short ciliary,and optic nerves
Optic and long ciliary nerves , ciliary ganglion
Ophthalmic and optic nerves, ciliary ganglion
63.A 22-year-old patient has a dry corneal surface due to a lack of moistening
fluid .Which of the following nerves is damaged?
(A)
(B)
(C)
(D)
(E)
Proximal portion of the lacrimal nerve
Zygomatic branch of the facial nerve
Lesser petrosal nerve
Greater petrosal nerve
Deep petrosal nerve
64. Which of the following statements concerning the tongue is correct?
(A) The palatoglossus muscles are innervated by the hypoglossal nerves
(B) Taste buds in the vallate papillae are innervated by the chorda tympani of
the facial nerve
(C) Its anterior two-thirds receives general sensory innervation from the facial
nerve
(D) It receives taste fibers from the facial and glossopharyngeal nerves
(E) It is retracted by the genioglossus
65.A patient has a functional impediment and cannot perform the act of swallowing .
Which of the following nerves is functioning normally
(A)
(B)
(C)
(D)
(E)
Hypoglossal nerve
Spinal accessory nerve
Vagus nerve
Facial nerve
Trigeminal nerve
66. Which of the following muscles would most likely open the jaw?
(A)
(B)
(C)
(D)
(E)
Masseter muscle
Medial pterygoid muscle
Lateral pterygoid muscle
Buccinator muscle
Temporalis muscle
67. Which of the following muscles would most likely open the eye?
(A)
(B)
(C)
(D)
(E)
Orbicularis oculi
Orbicularis oris
Frontalis
Levator palpebrae
Superior rectus
superioris
68.Fracture of the foramen rotundum would cause a lesion of which of the following
nerve?
(A)
(B)
(C)
(D)
(E)
Ophthalmic nerve
Optic nerve
Maxillary nerve
Mandibular nerve
Trochlear nerve
69.A lack of salivary secretion from the submandibular gland may indicate a lesion
of which of the following nervous structures?
(A)
(B)
(C)
(D)
(E)
Lingual nerve at its origin
Chorda tympani in the middle ear cavity
Superior cervical ganglion
Lesser petrosal nerve
Auriculotemporal nerve
70.Lack of accommodation results
muscles?
(A)
(B)
(C)
(D)
(E)
from paralysis of which of the following
Tarsal muscle
Sphincter pupillae
Dilator pupillae
Ciliary muscles
Orbitalis muscles
Match the following descriptions with the appropriate lettered structure in this
radiograph—a lateral view of the head
71.Structure that lies lateral to the lateral wall of the nasal cavity and inferior
to the floor of the orbit
72. Structure into which a middle ear infection may spread
73. Structure that has numerous small cavities and lies between the orbit and the
nasal cavity
74. Structure from which infection would spread into the anterior part of the middle
nasal meatus through the frontonasal duct
75. Structure in which cerebrospinal fluid(CSF) is formed by vascular choroid
plexus
Match the following descriptive statements with the approprriate lettered
structure in this magnetic
Resonance image(MRI)-a sagittal section through the head and neck
76.A lesion of the right nerve that innervates this structure would deviate this
structure to the left side
77.A lesion of the first cervical spinal nerve would cause impairment of function
of this structure
78.Tears may drain below this structure through the nasolacrimal duct.
79.The straight sinus runs long the line of attachment of the falx cerebri to this
structure
80.A tumor of this structure can be removed through the transphenoidal approach
following the septum of the nose through the body of the sphenoid.
Match the following description with the appropriate lettered structure in this
magnetic resonance image(MRI)-a transaxial section through the head.
81. Structure that mediates the afferent limb of the pupillary light reflex.
82. Structure that is formed by the perpendicular plate of the ethmoid
bone ,vomer,and septal cartilage
83. Structure that may be paralyzed as a result of infection of the cavernous sinus.
84. Structure that pierces the dural roof of the cavernous sinus between the
anterior and middle clinoid processes
85 Structure that may be obliterated by the pituitary tumor.
Match the following descriptions with the most appropriate sinus.
(A)
(B)
(C)
(D)
(E)
Cavernous sinus
Sigmoid sinus
Superior sagittal sinus
Transverse sinus
Straight sinus
86.Lies at the junction of the falx cerebri and the tentorium cerebelli
87.Curves laterally and forward in the convex outer border of the tentorium
cerebelli
88. Lies in the superior convex border of the falx cerebri.
89.Communicates
directly with the ophthalmic veins.
90.Becomes continuous with the internal jugular vein at the jugular foramen.
Match the following descriptive statements with the most appropriate opening of
the skull.
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
Foramen ovale
Foramen magnum
Petrotympanic fissure
Cribriform plate
Foramen rotundum
Pterygoid canal
Superior orbital fissure
Sphenopalatine foramen
Internal auditory meatus
Jugular foramen
91.Injury to the nerve passing through this structure causes a loss of general
sensation of the maxillary teeth.
92. Injury to the nerve passing through this structure causes a loss of sensation
of the temporomandibular joints
93.This structure is traversed by sensory fibers from the posterior one-third of
the tongue.
94. This structure is traversed by sensory fibers from the mucosa of the nasal
septum ,posterior lateral nasal wall,and anterior portion of the hard palate.
95 . This structure is traversed by preganglionic parasympathetic fibers to the
lacrimal gland.
For each clinical condition described ,select the lesion or other insult most
closely related to it.
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
(K)
Lesion of the glossopharyngeal nerve
Destruction of the supraorbital notch
Lesion of the facial nerve
Rupture of cerebral arteries
Lesion of the vagus nerve
Lesion of the trigeminal nerve
Rupture of cerebral veins
Lesion of the oculomotor nerve
Lesion of the trochlear nerve
Laceration of the middle meningeal artery
Lesion of the deep petrosal nerve
(L) Lesion of the greater
petrosal nerve
96.A radiograph of a patient’s skull reveals a fracture of the squamous part of
the temporal bone and a fracture line through the foramen spinosum.
97.After an automobile accident ,a 21-year-old women is unable to close her lips
98.A patient presents with a complaint of ptosis—dooping of an upper eyelid
99.A baseball pitcher who receives a blow on the head is found to have subdural
hematoma
100.A patient develops a vasodilation in the laccrimal gland.