Head and Neck Week 3

Question 1

Which nerve provides general sensory innervation to the lining of the oral cavity?

Answer 1

Cranial Nerve V3 (Third branch of the trigeminal nerve)

This is because the oral cavity is formed by ectoderm derived from the first pharyngeal arch which is associated with CN V.

Lecture: Development and Anatomy of the Oral Cavity

Objective 6: Describe the innervation of the tongue and linings of the oral cavity and pharynx in the context of their primordia: somites and the pharyngeal arches. Identify which pharyngeal arch nerve should be part of the segmental sensory innervation, but is not because the linings of its arch fail to grow. (MKS1a)

Question 2

Swallowing is split up into what three phases? In which phase(s) can dysphagia manifest?

Answer 2

1-Oral

2-Pharyngeal

3-Esophageal

Dysphagia can manifest in any of the 3 phases of swallowing

Lecture: Swallowing

Objective 1: Describe the neurophysiological organization of swallowing.

Question 3

This disorder, which is the most common cause of inspiratory stridor in children, is caused by the prolapse of supraglottic tissue into the airway.

Answer 3

Laryngomalacia

Symptoms include: failure to thrive and reflux

Lecture: Pediatric Airway

Objective 3: Characterize stridor and correlate the level of airway obstruction with the type of stridor [inspiratory, biphasic, expiratory] (MKS 1b)

Question 4

From which nerve do all of the laryngeal muscles (except the cricothyroid) receive branchiomotor innervation? Which cranial nerve is this nerve derived from?

Answer 4

Inferior laryngeal nerve

Derived from the Recurrent Laryngeal Branch of the Vagus Nerve (CN X)

Lecture: Anatomy of the Larynx

Objective 5: Describe the functions (and neuron components) of the superior and inferior (recurrent) laryngeal nerves. Describe how the cough reflex works. (MKS1a)

Question 5

If you accidentally punctured the anterior wall of the middle ear cavity during a procedure, which structure could you damage?

Answer 5

Internal carotid artery

Lecture: Ear Anatomy

Objective 4: Describe the relationships of the walls of the middle ear cavity to surrounding structures; identify the three ear ossicles and the muscles that attach to them; and describe how sound is transmitted to the inner ear. (MKS1a)

Question 6

What syndrome is the following pigmented lesion associated with? Is it benign or malignant?

Answer 6

Peutz-Jeghers Syndrome. This is a benign pigmented lesion.

This syndrome is also associated with hamartomatous polyps in the GI tract.

Lecture: Oral Cavity/Oropharynx

Objective 4: Enumerate the differential diagnosis of oral cavity lesions within the categories of benign pigmented, infectious, and autoimmune.

Question 7

Through which foramina do CNVII and VIII exit the skull?

Answer 7

Both CNVII and VIII pass through the internal acoustic meatus.

Lecture: Overview of the Cranial Nerves, VII & VIII

Objective 2: Identify their primordia and the cranial foramina they traverse. (MKS1a)

Question 8

When the fluid wave in the inner ear reaches the furthest part of the Scala Vestibuli, it can trigger hair cells at which part of the basilar membrane? What frequencies are detected here?

Answer 8

This is at the apex of the basilar membrane and cochlea. The basilar membrane is flaccid at this portion, allowing it to resonate at lower frequencies.

Lecture: Ear Function & Testing

Objective 1: Describe the basic mechanics of how the outer, middle, and inner ear transduce sound.

Question 9

What is the difference in etiologies of congenital and acquired choleasteatoma?

Answer 9

Congenital choleasteatoma is caused by entrapment of epithelial cells behind the tympanic membrane during development.

Acquired choleasteatoma is caused by the negative middle ear pressure from chronic Eustachian tube dysfunction which leads to the formation of a retraction pocket.

Lecture: Ear Infection & Pathology

Objective 4: Be able to discuss the pathogenesis and treatments for outer, middle, and inner ear disease.

Question 10

A patient presents with pain under his jaw during meals. He has a PMH of gout and is a current smoker. What is the most likely diagnosis?

Answer 10

Sialolithiasis. He most likely has a duct-obstructing stone in his submandibular salivary gland.

Lecture: Oral Cavity and Oropharynx

Objective 2: Distinguish between infectious, automimmune, and post-obstructive parotitis in adults ang children.