HNNS Important Questions II Flashcards
[Old PP]
State motor supply to stylopharyngeus.
Glossopharyngeal nerve
[Old PP]
State sensory supply to nasopharyngeal recess (fossa of Rosenmüller) .
Maxillary nerve (CN V2)
[Old PP]
State the sensory supply to piriform fossa.
Internal laryngeal nerve (CN X)
[Old PP]
State the motor supply to middle pharyngeal constrictor.
Pharyngeal plexus (CN X)
[Old PP]
Which of following statements regarding nasopharynx is INCORRECT?
A. At roof of nasopharynx lies a collection of adenoid tissue called pharyngeal tonsils.
B. Pharyngeal recess is a common site for nasopharyngeal carcinoma.
C. Sensory nerve supply to nasopharynx is by mandibular division of trigeminal nerve.
D. Opening of auditory tube is found at lateral region of nasopharynx.
E. Nasopharynx is located behind posterior aperture of nasal cavity.
C
Maxillary nerve (CN V2)
Posterior apertures of nasal cavity: choanae
[PP]
Mid-shaft clavicular fracture.
Which muscle is responsible for the upward displacement of the proximal fragment?
A. Pectoralis major
B. Sternocleidomastoid
C. Subclavius
D. Trapezius
B
[PP]
The vestibule of the larynx is located above the true vocal cords. What is the sensory innervation of this region?
A. External laryngeal nerve
B. Inferior laryngeal nerve
C. Internal laryngeal nerve
D. Recurrent laryngeal nerve
C
Supraglottic region: internal laryngeal nerve (branch of superior laryngeal nerve)
Subglottic region: recurrent laryngeal nerve
[PP]
Miss Wong underwent left hemithyroidectomy 2 weeks ago and has recovered well. However, when she returned to work as a singing teacher, she found that she had difficulty in singing the soprano range. Other than that, she is able to speak normally and eat normally. What structure is MOST LIKELY to be damaged during the operation leading to the present symptom? A. External branch of left superior laryngeal nerve
B. Left recurrent laryngeal nerve
C. Left true vocal cord
D. Left vagus nerve
A
Superior laryngeal nerve
1. External laryngeal nerve
-> cricothyroid (lengthen vocal cord)
-> damage: X high-pitched voice
- Internal laryngeal nerve
-> sensory Innervation to supraglottic region
Recurrent laryngeal nerve
-> all intrinsic muscles of larynx except cricothyroid
-> unilateral damage: hoarseness of voice (vocal cord palsy), choking
-> bilateral damage: airway obstruction
-> sensory innervation to subglottic region
Damaged vagus nerve -> hoarseness of voice, choking
Damaged vocal cord -> hoarseness of voice
[PP]
A patient has Horner syndrome, with ptosis and miosis. The presynaptic sympathetic fibres that are affected MOST LIKELY travel through the white ramus of which spinal nerve?
A. C2
B. L1
C. L5
D. T1
D
T1-T3
[PP]
Acoustic startle reflex is a defensive response triggered by a sudden loud noise of > 80 dB. Which neural area plays an important role in generating the startle response?
A. Inferior colliculus
B. Inferior olive
C. Lateral lemniscus nucleus
D. Trapezoid body
A
[PP]
Vestibular apparatus in the inner ear senses head movements. What is the stimulus that excites sensory hair cells underneath the otoconia crystals?
A. Endolymph motion
B. Optokinetic input
C. Perilymph motion
D. Rotational motion
E. Translational motion
E
Otoconia crystals: translational motion
Cupula: endolymph motion
[PP]
To test the language ability of a patient, a neurologist asks the patient to describe the picture. Which brain region is involved in the comprehension of language?
A. Amygdala
B. Broca area
C. Putamen
D. Wernicke area
D
Broca’s area (44, 45): motor, produce language
Wernicke’s area (22): comprehension of language
[PP]
A 55-year-old man had trouble reading the newspaper. The visual field examination showed a right homonymous inferior quadrantic hemianopia/quadrantanopia. Lesion at which location would MOST LIKELY correlate with his visual problem?
A. Left Meyer’s loop
B. Left superior bank of primary visual cortex
C. Right lateral geniculate nucleus
D. Right parietal optic radiation
B
A: right homonymous superior quadrantanopia
D: left homonymous inferior quadrantanopia
[PP]
A patient has dementia from Alzheimer disease. Which brain region is MOST LIKELY to show early neuronal loss?
A. Entorhinal cortex
B. Insula
C. Pineal gland
D. Putamen
A
In hippocampal formation
[PP]
A patient suffered from Parkinson disease for 10 years and later developed cognitive dysfunction and sleep disturbance.
List two structures of the brain which display neurodegeneration at the early stage of Parkinson disease. (2 marks)
Caudate nucleus
Putamen
Globus pallidus
Subthalamic nucleus
[PP]
A patient suffered from Parkinson disease for 10 years and later developed cognitive dysfunction and sleep disturbance.
Which degenerated region of the brain caused his cognitive dysfunction? (1 mark)
Frontal cortex
[PP]
A patient suffered from Parkinson disease for 10 years and later developed cognitive dysfunction and sleep disturbance.
Which region of his brainstem caused his sleep disturbance? (1 mark)
Reticular formation
[PP]
A patient suffered from Parkinson disease for 10 years and later developed cognitive dysfunction and sleep disturbance.
What is the name of patient’s current neurodegenerative disease? (1 mark)
Parkinson’s Disease Dementia (PDD)
[PP]
A motorcyclist was sent to the Accident and Emergency Department after a traumatic injury to the left side of the head. The mandible and temporal bone were fractured. Epidural haematoma was suspected.
Injury to which nerve might cause sensory disturbances to his lower lip and chin? (1 mark)
Inferior alveolar nerve
[PP]
A motorcyclist was sent to the Accident and Emergency Department after a traumatic injury to the left side of the head. The mandible and temporal bone were fractured. Epidural haematoma was suspected.
Which two nerves might be damaged if the salivary secretion was affected? (2 marks)
Lingual nerve (chorda tympani)
Auriculotemporal nerve
[PP]
Which damaged artery lead to epidural haematoma? Which foramen transmits this artery? (2 marks)
Middle meningeal artery
Foramen spinosum
[PP]
Which blood vessel relates to the anterior wall of structure Y? (1 mark)
Internal carotid artery
[PP]
Which blood vessel relates to the inferior wall of structure Y? (1 mark)
Internal jugular vein
[PP]
What are the two main histopathological hallmarks in AD brain? (2 marks)
- (Extracellular) amyloid plaques
- (Intracellular) neurofibrillary tangles
- abnormal form of microtubule-associated protein tau
[PP]
The rare forms of Alzheimer’s disease (AD) with onset before the age of 60 are heritable.
Name two genes in which mutations have been found to cause onset of AD before the age of 60. (2 marks)
APP
PSEN1
PSEN2
[PP]
Name one type of cognitive deficit in AD patients. (1 mark)
Impaired memory
Attentional and executive deficits
Language and knowledge deficits
Visuospatial and perceptual abilities deficits
[PP]
What is the predominant inflammatory cell type that is recruited into the cerebrospinal fluid or abscess cavity that is involved in the defense against acute bacterial infection? (1 mark)
Neutrophils
[PP]
Name at least two bacterial organisms that can commonly cross the barrier to enter the brain to set up acute infection in the leptomeninges in a previously healthy child.
(2 marks)
Neisseria meningitidis
Haemophilis influenzae
Streptococcus pneumoniae
[PP]
Bacteria can set up acute infection in the central nervous system in form of diffuse infection of the subarachnoid space, or forming abscesses within the cerebral cortical grey and white matter, morphologically characterised by pus formation.
Name two predisposing factors that can facilitate entry of bacteria into the cerebral cortical grey or white matter to set up abscess cavity. (2 marks)
Haematogenous (e.g. bacterial endocarditis, lung abscess)
Direct penetrating injury breaching the skull bone
Adjacent sepsis spreading into the brain (e.g. otitis media)
[PP]
Explain why the hand usually has shorter discrimination distance than the forearm. (2 marks)
Compared to the forearm, the hand has
- higher density of tactile receptors
- smaller receptor field of tactile sensation
