Head and Neck Week 1

Question 1

Which pairing of nerve to pharyngeal arch is correct?
Arch 1, facial nerve
Arch 2, vagus
Arch 3, glossopharyngeal
Arch 4, trigeminal

Answer 1

Correct: Arch 3, glossopharyngeal

Correct pairings:
Arch 1: innervated by branches of the trigeminal nerve
Arch 2: innervated by branches of the facial nerve
Arch 3: innervated by branches of the glossopharyngeal nerve
Arch 4: innervated by branches of the vagus nerve

Lecture: Pharyngeal (Branchial) Arches
Objective 3. Describe the adult derivatives of the respective arches, and the cranial nerve associations with each (MKS 1a)

Question 2

Which cranial nerve passes through the body of the parotid gland?

Answer 2

Answer: Facial (VII)

Lecture: Superficial Face and Skull Interior
Objective 1: Identify the motor and sensory nerves of the face and relate the territories of the sensory branches of the trigeminal nerve to the embryonic primordia of the head. (MKS1a)

Question 3

What is the most common bacterial species in otitis externa? What is the usual source of this species?

Answer 3

Usually from water in the ear or skin trauma in the ear canal, which leads to pseudomonas colonization (b/c they live in water). Staph aureus is another common one.

Lecture Head and Neck Microbiology

Objective 5. Differentiate the clinical syndromes of acute otitis externa and malignant otitis externa and identify the usual bacterial etiology of each. (MKS-1b)

Question 4

Name the branches of the facial nerve, from superior to inferior

Answer 4

Temporal
Zygomatic	
Buccal
Mandibular
Cervical

Lecture: Superficial Face and Skull Interior
Objective 1: Identify the motor and sensory nerves of the face and relate the territories of the sensory branches of the trigeminal nerve to the embryonic primordia of the head. (MKS1a)

Question 5

Which pairing of pharyngeal arch to derived muscle is correct?

Arch 1: Muscles of mastication
Arch 2: Anterior and posterior bellies of the digastric muscle
Arch 3: Muscles of facial expression
Arch 4: Stylopharyngeus

Answer 5

Answer:
Arch 1: Muscles of mastication

Correct pairings:
Arch 1 (innervated by the trigeminal nerve) gives rise to the muscles of mastication as well as the tensor tympani, mylohyoid, tensor veli palatine, and the anterior belly of the digastric.
Arch 2 (innervated by the facial nerve) gives rise to the muscles of facial expression as well as the stapedius, stylohyoid, and posterior belly of the digastric
Arch 3 gives rise to the sylopharyngeus
Arch 4 gives rise to the pharyngeal and laryngeal musculature

Lecture: Pharyngeal (Branchial) Arches
Objective 3. Describe the adult derivatives of the respective arches, and the cranial nerve associations with each (MKS 1a)

Question 6

What is the most common bacterial cause of pharyngitis in children? In adults?

Answer 6

Group A strep for both.

Lecture Head and Neck Microbiology

Objective 1. Recognize the major bacterial pathogens associated with pharyngitis, otitis, sinusitis and periorbital and orbital cellulitis. (MKS-1b)

Question 7

Which nerves and arteries pass through the cavernous sinus?

Answer 7

Nerves III, IV, VI, V1, and V2,and the internal carotid artery

Lecture: Superficial Face and Skull Interior
Objective 10. Identify the cranial nerves as they pierce the dura mater and pass through the cranial foramina. (MKS1a)

Question 8

Which nerve travels with the superficial temporal artery and vein?

Answer 8

Auriculotemporal nerve

Lecture: Superficial Face and Skull Interior
Objective 1: Identify the motor and sensory nerves of the face and relate the territories of the sensory branches of the trigeminal nerve to the embryonic primordia of the head. (MKS1a)

Question 9

A patient presents with absent superior parathyroid glands. Which of these branchial structures likely failed to differentiate? What is the name of this syndrome?

a. Branchial Pouch 1
b. Branchial Arch 2
c. Branchial Arch 1
d. Branchial Pouch 4

Answer 9

D. the superior parathyroid glands are formed from Branchial Pouch 4. Failure of the 3rd and 4th arches to differentiate is called DiGeorge Syndrome.
Pouch 1 gives rise to the middle ear chamber and Eustachian tube
Arch 2 gives rise to the muscles of facial expression and other muscles innervated by CNVII
Arch 1 gives rise to the muscles of mastication (innervated by CN V)
The 3rd pouch gives rise to the thymus and interior parathyroid.

Lecture: Pharyngeal (Branchial) Arches
Objective 4. Identify the primary clinical syndromes associated with arch malformations. (MKS 1a)

Question 10

What is the difference between periorbital cellulitis and orbital cellulitis? Why is this important?

Answer 10

Orbital cellulitis is a serious infection that involves the muscle and fat located within the orbit. Peri-orbital cellulitis is outside the orbit. Within the orbit, patients present with ophthalmoplegia, pain with eye movement, and/or proptosis. The diagnosis of orbital cellulitis can be confirmed by CT and/or MRI. Treatment of orbital cellulitis includes antibiotics and may require surgery, while periorbital cellulitis is less severe.

Lecture Head and Neck Microbiology
Objective 6. Differentiate the clinical syndromes of periorbital cellulitis and orbital cellulitis and identify the usual microbial etiology of each. (MKS-1b)

Question 11

A chordoma is a rare neoplasm in adults that is derived from what structure? When do they typically appear?

Answer 11

Persistent portions of the notochord. Chordomas are slow growing and appear in the 3rd-4th decade or later.

Skull – Introduction and Organization
Objective: 5. Summarize postnatal growth processes and patterns in relation to features and functions. (MKS-1a)