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anat - head and neck Flashcards

1
Q

Which muscles of mastication form a powerful ‘muscular sling’ and act to close the jaw?

A
  1. medial pterygoid muscle
  2. masseter
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2
Q

what are the 5 branches of facial nerve CNVII?

A

temporal
zyogmatic
buccal
marginal mandibular
cervical

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3
Q

what supplies blood to the entire eyeball?

A

ophthalmic artery

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4
Q

which soft palate muscle is innervated by CNV3?

A

tensor veli palatini

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5
Q

which nerve innervates all soft palate muscles except tensor veli palatini?

A

CNX (vagus)

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6
Q

what nerve innervates muscles of tongue?

A

CNXII (hypoglossal)

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7
Q

which tongue muscle is innervated by CNX?

A

palatoglossus

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8
Q

Which “strap” muscle crosses through both the anterior and posterior triangles of the neck?

a. Stylohyoid
b. Sternothyroid
c. Sternohyoid
d. Omohyoid

A

d. omohyoid
anterior: superior omohyoid
posterior: inferior omohyoid

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9
Q

What two structures pass through the space between the anterior and middle scalene muscles?

A

brachial plexus
subclavian artery

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9
Q

What two structures pass through anterior to anterior scalene muscle?

A

phrenic nerve
subclavian vein

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10
Q

where do the inferior thyroid arteries branch from?

A

thyrocervical trunk

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11
Q

where does the inferior thyroid vein drain into?

A

brachiocephalic vein

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12
Q

where do superior thyroid arteries branch from?

A

external carotid artery

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13
Q

where do superior and middle thyroid veins drain into?

A

internal jugular vein

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14
Q

What structure is at risk during surgical excision of the thyroid due to its position in the tracheo-oesophageal groove?

What is the corresponding complication?

A

recurrent laryngeal nerve

unilateral damage: hoarse voice
bilateral damage: total loss of abduction of vocal cords –> respiratory distress and death by asphyxiation

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15
Q

what foramen does middle meningeal a. pass through? and which part of the sphenoid bone is this foramen at?

A

foramen spinosum
greater wing of sphenoid bone

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16
Q

what are the contents of cavernous sinus?

A

O TOM CAT

  • Oculomotor n (CNIII)
  • Trochlear n (CNIV)
  • Ophthalmic n (CNV1)
  • Maxillary n (CNV2)
  • ICA
  • Abducens n (CNVI)
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17
Q

which nerve does glossopharyngeal nerve (CNIX) hitchhike on to innervate parotid gland?

A

auriculotemporal nerve (CNV3)

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17
Q

what nerves does PNS fibres from CNVII hitchhike on to innervate lacrimal gland?

A

zygomatic n. (CNV2) –> lacrimal n. (CNV1)

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17
Q

what nerve does chorda tympani (CNVII) hitchhike on to provide sensory innervation to anterior 2/3 of tongue?

A

lingual nerve (CNV3)

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18
Q

at what spinal level does CCA bifurcate?

A

C4

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19
Q

which condition is forehead sparing:
Bell’s palsy or stroke

A

stroke (central lesion)
- bilateral innervation of forehead

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20
Q

which nerve is most commonly affected in an ICA aneurysm?

A

abducens nerve (CNVI) –> close proximity to ICA and lack of structural support that nerves in lateral wall have

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21
Q

damage to to CNIV (trochlear nerve) will result in what kind of diplopia?

horizontal/vertical

A

vertical diplopia
superior oblique m. affected –> eyes cannot depress when adducted

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22
Q

damage to to CNVI (abducens nerve) will result in what kind of diplopia?

horizontal/vertical

A

horizontal
lateral rectus m. affected –> unopposed action of medial rectus –> affected eye looks medially

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23
Q

what are the 3 main structures that go through the parotid gland?

A

facial nerve, retromandibular vein, ECA (superficial to deep)

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24
Q

which muscle of mastication depresses the mandible?

A

lateral pterygoid (depress and protract)

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25
Q

which muscle of mastication is attached to joint capsule of TMJ?

A

lateral pterygoid

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26
Q

which artery provides the main source of arterial supply to infratemporal fossa?

A

maxillary artery

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27
Q

A brisk hyperactive repeating jaw jerk is most likely to indicate an upper motor neuron lesion to the ____ nerve?

A

trigeminal nerve

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28
Q

What would a complete lesion of the oculomotor nerve produce?

a. Nystagmus
b. Diplopia in lateral gaze toward the affected side
c. Medial deviation of the affected eye
d. Proptosis (bulging of eye)
e. Closure of the affected eye

A

e. closure of affected eye (LPS not working to open eye)

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29
Q

fracture through roof of maxillary sinus would result in sensory loss to which of the following areas?

a. skin of forehead
b. upper molar teeth
c. upper incisor and canine teeth
d. upper eyelid
e. lacrimal gland

A

c. upper incisor and canine teeth
anterior superior alveolar nerve (CNV2) runs along floor of orbit

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30
Q

which nerve does piriform fossa receive innervation from?

A

internal laryngeal nerve (branch of CNX)

31
Q

which nerve runs along floor of mouth and wraps around submandibular duct?

A

lingual nerve

32
Q

which extrinsic tongue muscle has a different innervation?
a. Genioglossus
b. Hyoglossus
c. Styloglossus
d. Palatoglossus

A

d. palatoglossus (CNX)

the rest are innervated by CNXII

33
Q

what artery courses transversely just medial to neck of mandibular condyle?

A

maxillary artery

34
Q

which nerve passes through malleus and incus?

A

chorda tympani

35
Q

which paranasal sinuses drain into middle meatus?

A

frontal, anterior and middle ethmoid, maxillary (into semilunar hiatus)

36
Q

which paranasal sinuses drain into superior meatus?

A

posterior ethmoid, sphenoid

37
Q

what haemorrhage is associated with loss of consciousness –> lucid interval –> coma?

A

epidural haemorrhage

38
Q

“worst headache ever”
what haemorrhage?

A

subarachnoid haemorrhage

39
Q

Sienna is diligent about her skin care routine but on this particular day can’t help but pop a pimple located on the side of her nose. It gives her great relief, but a few days later, she develops a fever, headache, and confusion. Infection of the venous sinuses is found. What was the likely cause of the infection?

a) Maxillary sinus
b) Superior ophthalmic vein
c) Inferior ophthalmic vein
d) Facial vein

A

d. facial vein (infection of cavernous sinus)

40
Q

An absent gag reflex is likely a consequence of dysfunction of:

a) Sensation component: CN IX; motor component: CN X
b) Sensation component: CN IX; motor component: CN XI
c) Sensation component: CN X; motor component: CN XII
d) Sensation component: CN XII; motor component: CN XII

A

a. sensation: CNIX; motor: CNX

motor: pharyngeal muscle contraction + soft palate elevation

41
Q

The corneal reflex involves:

a) Sensation component: CN V; motor component: CN VII
b) Sensation component: CN V; motor component: CN V
c) Sensation component: CN VII; motor component: CN III
d) Sensation component: CN V; motor component: CN III

A

a. sensation: CNV; motor: CNVII (orbicularis oculi)

42
Q

The jaw jerk reflex involves:

a) Sensation component: CN V; motor component: CN VI
b) Sensation component: CN V; motor component: CN V
c) Sensation component: CN VI; motor component: CN V
d) Sensation component: CN VII; motor component: CN V

A

b. sensation: CNV; motor: CNV

43
Q

The pupillary reflex involves:

a) Sensation component: CN II; motor component: CN II
b) Sensation component: CN III; motor component: CN III
c) Sensation component: CN II; motor component: CN III
d) Sensation component: CN III; motor component: CN II

A

c. sensation: CNII; motor: CNIII

44
Q

Dentists usually block the inferior alveolar branch of a nerve. Which other branch is usually implicated too?

A

lingual nerve
both nerves travel together within mandibular canal and emerge at mental foramen

45
Q

If a tumour were to cause narrowing of the jugular foramen, which of the following structures would be compressed as a result?

a.Glossopharyngeal nerve
b. Vagus nerve
c. Spinal accessory nerve
d. Internal jugular vein
e. All of the above

A

e. all of the above

46
Q

the site of epistaxis is considered as the anastomoses between:

a. anterior ethmoidal and posterior ethmoidal arteries
b. internal and external carotid arteries
c. sphenopalatine and greater palatine arteries
d. nasal and greater palatine arteries

A

b. internal and external carotid arteries

47
Q

Which of the following is not a feature of myopia?

a. Excessively rounded lens
b. Excessively long eye
c. Excessively curved cornea
d. Excessively flattened cornea

A

d. excessively flattened cornea (in hyperopia)

48
Q

Which of the following is not a symptom of diabetic retinopathy?

a. Cotton wool spots
b. Aura/halo around lights
c. Partial loss of acuity
d. Scotomas

A

b. aura/halo around lights

49
Q

The temporomandibular joint is innervated by the:

a. Mandibular nerve
b. Maxillary nerve
c. Facial nerve
d. Vestibulocochlear nerve

A

a. mandibular nerve

50
Q

The superior orbital fissure contains all of the following except:

a. Abducens nerve
b. Superior ophthalmic vein
c. Ophthalmic artery
d. Ophthalmic nerve

A

c. ophthalmic artery (goes through optic canal)

51
Q

The external carotid artery travels through the carotid canal.

a. True
b. False

A

b. False

ICA passes through carotid canal

52
Q

All of the following nasal sinuses drain into the semilunar hiatus except:

a. Frontal sinuses
b. Anterior cells of ethmoidal sinuses
c. Maxillary sinuses
d. Sphenoid sinuses

A

d. Sphenoid sinuses (drain into sphenoethmoidal recess)

53
Q

The anterior ethmoidal artery supplies all of the nasal sinuses except:

a. Frontal sinuses
b. Ethmoidal sinuses
c. Maxillary sinuses
d. Sphenoid sinuses

A

c. maxillary sinus (supplied by maxillary artery, branch of ECA)

54
Q

Which laryngeal structure is used to insert a hollow needle to assist in breathing?

a. Thyroid cartilage
b. Cricoid cartilage
c. Cricothyroid ligament
d. Thyrohyoid membrane

A

b. cricoid cartilage

55
Q

The orbicularis oris muscle functions to

a. Open the lips
b. Close the lips
c. Evert the upper lip
d. Evert the lower lip

A

b. Close the lips

56
Q

A patient presents with contralateral homonymous hemianopia with macular sparing – which part of the optic pathway is damaged?

a. Lateral geniculate nucleus
b. Optic chiasm
c. Upper optic radiation
d. Primary visual cortex

A

d. Primary visual cortex (occipital lobe)

57
Q

After boxing with a kangaroo, a patient presents with contralateral inferior quadrantanopia. Where is the suspected optic lesion?

a. Optic nerve
b. Lateral geniculate nucleus
c. Upper optic radiation
d. Lower optic radiation

A

c. Upper optic radiation (Baum’s loop)

58
Q

A patient complains of being unable to close their left eyelid. Which of the following is damaged?

a. Optic nerve
b. Oculomotor nerve
c. Trochlear nerve
d. Facial nerve

A

d. facial nerve
orbicularis oculi damaged

59
Q

A patient cannot feel the anterior 2/3 of her tongue. Which cranial nerve lesion would be suspected?

a. Facial nerve
b. Trigeminal nerve
c. Glossopharyngeal nerve
d. Hypoglossal nerve

A

b. trigeminal nerve (CNV3) –> lingual nerve

60
Q

Which of the following will not appear as signs of left CN VII palsy?

a. Loss of lacrimation in the left eye
b. Decrease in salivation
c. Decrease in balance
d. Hypersensitivity to sound

A

c. decrease in balance

d. loss of innervation of stapedius muscle of inner ear –> increased sensitivity to sounds (stapes usually dampens intensity of sounds)

61
Q

Which nerve provides sensory innervation to the middle ear?

a. Vagus nerve
b. Glossopharyngeal nerve
c. Facial nerve
d. Vestibulocochlear nerve

A

b. Glossopharyngeal nerve

62
Q

A left vagus nerve lesion will present with:

a. Left uvula deviation
b. Right uvula deviation
c. Right tongue deviation
d. Left tongue deviation

A

b. Right uvula deviation

uvula deviate away from side of lesion

63
Q

what nerve provides sensory innervation to external ear?

A

auriculotemporal nerve (branch of CNV3)

64
Q

A hypoglossal nerve lesion will present with:

a. Contralateral uvula deviation
b. Ipsilateral uvula deviation
c. Contralateral tongue deviation
d. Ipsilateral tongue deviation

A

d. Ipsilateral tongue deviation

65
Q

the middle meningeal artery goes through bifurcation of _____ nerve

A

auriculotemporal nerve

66
Q

Nerve to mylohyoid innervates mylohyoid muscle, and which other muscle?

A

anterior belly of digastric m.

67
Q

The thyroid gland has an anastomosis between major arterial vessels. Which 2 vessels contribute?

a. Internal carotid artery
b. Subclavian artery
c. External carotid artery
d. Axillary artery

A

b. subclavian artery
c. external carotid artery

68
Q

A 20-year-old man seen in Emergency has sustained a stab injury to the neck during a pub brawl. The stab wound is located above the right clavicle, just lateral to the sternocleidomastoid and
could be life-threatening due to possible injury to the …

A. axillary artery
B. brachial plexus
C. internal jugular vein
D. subclavian artery
E. thoracic duct

A

D. subclavian artery

69
Q

Compression of the maxillary artery in the pterygopalatine fossa would result in altered blood supply to which location?

a. orbit
b. nasal cavity
c. palate, nasal cavity & orbit
d. palate

A

c. palate, nasal cavity & orbit

70
Q

Damage to the facial nerve as it exits the stylomastoid foramen would result in what clinical outcomes?

a. altered tear production
b. Decreased salivation
c. altered taste to anterior 2/3rds of tongue
d. droopy facial features

A

d. droopy facial features

71
Q

A patient is unable to rotate their left eye to the left (lateral rotation/extorsion). Which muscle is not functioning properly?

a. Superior oblique
b. Inferior oblique
c. Lateral rectus
d. Medial rectus

A

b. Inferior oblique

72
Q

Which of the following arteries, when occluded, can cause blindness?

a. Central retinal artery
b. Supratrochlear artery
c. Lacrimal branch of ICA
d. Ophthalmic artery

A

a. Central retinal artery

73
Q

Which of the following separates the nasopharynx from the oropharynx?

a. Choanae
b. Pharyngeal isthmus
c. Oropharyngeal isthmus
d. Laryngopharyngeal isthmus

A

c. Oropharyngeal isthmus

74
Q

Which of the following is false regarding the danger space?

a. Potential path for infection spread from pharynx to mediastinum
b. Positioned posterior to retropharyngeal space
c. Contains retropharyngeal nerve + pharyngeal plexus
d. Located between alar fascia + prevertebral fascia

A

c. Contains retropharyngeal nerve + pharyngeal plexus

75
Q

what is the retropharyngeal space bounded by?

A

buccopharyngeal fascia (anterior) and alar fascia (posterior)

76
Q

Both the trapezius and sternocleidomastoid are enclosed by the investing layer of the deep cervical fascia.
a. True
b. False

A

a. true

77
Q

The platysma muscle is contained by the superficial cervical fascia.
a. True
b. False

A

a. True

78
Q

The external jugular vein passes through the anterior triangle of the neck.
a. True
b. False

A

b. false
EJV in posterior triangle

head and neck (3 decks)

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