RANZCR-Like ANA Qs

Question 1

Describe the course of the facial nerve, starting from the brainstem until it exits the skull base.
(3 Marks)

(2018, Q1 a)

Answer 1

1) x 2 pontine roots (motor, sensory) which course together until facial canal. Exiting the pons laterally at travelling through cerebellar pontine angle,
2) Travel through IAM in petrous temporal bone
3) Enter 4cm fallopian (facial) canal
4) Within Fallopian: Roots fuse to form facial nerve,
- Geniculate ganglion (knee turns inferiorly)
- Branches: Stapedius, greater petrosal, chorda tympani
5) Curves inferomedially to exits via stylomastoid foramen

Question 2

Describe the course of the maxillary branch of the trigeminal nerve.
(3 marks)

(2018, Q1 b)

Answer 2

1) Arises from the anterior edge of the trigeminal ganglion. In Meckels cave.
2) Anterior course through the lateral dural wall of the cavernous sinus, inferiorly and laterally to the ophthalmic nerve. Menigeal branch in middle cranial fossa.
3) Exits middle cranial fossa via foramen rotundum and enters the upper part of the pterygopalatine fossa. Gives off branches to the pterygopalatine ganglion.
4) Inferior orbital fissure becomes infraorbital nerve

Question 3

With the aid of a table, list the boundaries of the hypopharynx
(2 marks)

(2018, Q1 c)

Answer 3

Sup: Upper boarder epiglottis (level of hyoid)
Inf: Lower boarder of cricoid - continuous w/eosophagus.
Ant: Laryngeal inlet
Post: C3 to C6

Question 4

List the subparts of the hypopharynx and the lymphatic drainage for
each subpart.
(2 marks)

(2018, Q1 d)

Answer 4

1) pyriform sinus - unilaterally drain primarily to the upper and middle jugular nodes, may also drain prelaryngeal.
2) postcricoid region - bilaterally middle and lower jugular nodes and to the paratracheal nodes.
3) posterior wall - jugular nodes and retropharyngeal nodes

Question 5

List the lymphatic drainage for a lesion located in the lateral part of the
left oral tongue.

(1 mark)
(2018, Q1 e)

Answer 5

LEFT!!!!!! Sub mandibular nodes. Can also drain direct to deep cervical.

Drain then to deep cervical (Level II)

Question 6

List the borders of the pterygopalatine fossa.

3 marks
(2018, Q1 f)

Answer 6

Anterior: Posterior wall of the maxillary sinus.
Posterior: Pterygoid process of the sphenoid bone.
Inferior: Palatine bone and palatine canals.
Superior: Inferior orbital fissure of the eye.
Medial: Perpendicular plate of the palatine bone
Lateral: Pterygomaxillary fissure