Block 5 Anatomy Wk 4 From Ta's W Exp
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- 1.
A 26-year-old singer visits her physician, an ear, nose, and throat (ENT) surgeon, and complains of changes in her voice. A laryngoscopic examination demonstrates a lesion of the superior laryngeal nerve, causing weakness of which of the following muscles?
- A.
Cricothyroid
- B.
Middle pharyngeal constrictor
- C.
Thyroarytenoid
- D.
Thyrohyoid
Correct Answer
A. CricothyroidExplanation
innervated by external branch of Superior Laryngeal NerveRate this question:
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- 2.
A patient comes to your office complaining of right lower jaw pain. Upon inspection of the mouth, you find an abscess on the 2nd right mandibular molar. What nerve could you anesthetize to relieve the pain?
- A.
Greater palatine nerve
- B.
Lesser palatine nerve
- C.
Superior alveolar nerve
- D.
Inferior alveolar nerve
- E.
Nasopalatine nerve
Correct Answer
D. Inferior alveolar nerveExplanation
Key word is mandibularRate this question:
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- 3.
As your friend is traveling the plains of northern Wyoming in early June, he encounters an old injun who prides himself in collecting teeth from the white men. However, due to his belief in the Moon Man taking vengeance on those who cause pain he injects his homeprep of nerve block to remove the upper premolars bilaterally. In what nerve(s) would he like to inject the nerve block to inhibit pain sensation from the periodontal ligament, teeth or alveolar process?
- A.
Buccal branch of Lingual
- B.
Infraorbital nerve just above the canine fossa
- C.
Greater Palatine Nerve before it leaves the Greater palatine foramen
- D.
Just as the nasopalatine leaves the incisor foramen
- E.
Maxillary Nerve after the Pterygopalatine ganglion
Correct Answer
E. Maxillary Nerve after the Pterygopalatine ganglionExplanation
The superior dental plexus (for the premolars mostly the middle superior alveolar nerves) begins to receive its contributions after V2 passes the pterygopalatine ganglion. The buccal branch supplies the buccal gingiva. The infraorbital might supply a little of the gingiva in the maxillary teeth. Greater palatine nerve does sensation to hard palateRate this question:
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- 4.
While on a bus traveling north from Leticia in the Colombian Amazon you encounter a woman who asks you for your saliva. At first this seems a little strange but later you learn that she wants to use it to produce her home-made chicha beverage that requires salivary amylase to allow the bacteria to ferment the sugars in the maize and mandioca. You agree and she begins massaging on the sides of your jaw in order to increase blood flow to your sublingual and submandibular glands. To increase blood flow to both of these glands she wants to stimulate blood flow from which artery?
- A.
Inferior alveolar artery
- B.
Facial Artery
- C.
Lingual artery
- D.
Sphenopalatine Artery
Correct Answer
B. Facial ArteryExplanation
Facial artery - facial artery gives off the submental artery that according to Dr. Dhiman's oral cavity lecture supplies both sublingual and submandibular glands. Lingual artery supplies bloodflow to the sublingual gland but not to the submandibular.Rate this question:
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- 5.
What nerve fibers synapse in the pterygopalatine ganglion?
- A.
GVA Sympathetic fibers of the Nerve to the Pterygoid canal
- B.
GVE Sympathetic fibers the Greater Petrosal nerve
- C.
GVE Parasympathetic fibers of the Oculomotor Nerve
- D.
GVE Parasympathetic fibers of the Nerve of the Pterygoid canal
- E.
GVA Parasympathetic fibers of the Nerve of the Pterygoid canal
Correct Answer
D. GVE Parasympathetic fibers of the Nerve of the Pterygoid canalExplanation
Greater Petrosal Nerve (VII) joins with Deep Petrosal Nerve (SNS) to form Nerve of the Pterygoid Canal which carries GVE (PSNS and SNS), GVA, and SVA (from palate). Only PSNS GVE synapse in PPG.Rate this question:
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- 6.
Ned despises Pro-quarterback Matt Hasselback so much that he punches him in the nose. Since you’re a caring medical student with a wealth of anatomy knowledge, you help him stop the epistaxis by applying pressure to Kiesselbach’s area. This area receives blood from which branch(es) of the external carotid artery?
- A.
Ophthalmic
- B.
Maxillary
- C.
Facial
- D.
B&C
- E.
All of the Above
Correct Answer
D. B&CExplanation
Ophtalmic Artery contributes blood to the anastamosis but it’s a branch of the internal carotid artery.Rate this question:
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- 7.
Matt Hasselback retaliates on Ned by punching him in the right eye. Ned suffers a blowout fracture resulting in herniation of orbital soft tissues into one of his paranasal sinuses. On the below MRI, which arrow indicates the most likely area of herniation?
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
C. CExplanation
blow-out fracture refers to fracturing the orbital floor, so soft tissue may herniate into the maxillary sinus.Rate this question:
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- 8.
Due to his love for the Backstreet Boys, Paul hyperventilates every time a song comes on. After spending months listening to them, what clinical syndrome is he likely to have?
- A.
Metabolic alkalosis
- B.
Atelectasis
- C.
Thoracic outlet syndrome
- D.
Horner’s
- E.
Metabolic acidosis
Correct Answer
C. Thoracic outlet syndromeExplanation
habitual hyperventilation can lead to hypertrophy of the accessory muscles of respiration including the anterior and middle scalenes which can compress the brachial plexus and/or subclavian artery. Hyperventilation does cause respiratory alkalosis which will be compensated by healthy kidneys (but not to the point of acidosis).Rate this question:
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- 9.
A 15 year old boy falls from his bicycle and hits his head. His initial examination in the ER is normal, but later in the day, he becomes noticeably lethargic. He is brought back to the ER where he is too drowsy to answer the examiner's questions. His right pupil is 7mm and his left is 4mm. Patellar tendon reflexes are brisker on the left, and a Babinski sign can be elicited on the left. CT imaging reveals that a pool of blood has displaced the right temporal lobe to the left. The hematoma is evacuated, and a blood vessel is cauterized. Through which opening did the lacerated blood vessel enter the cranial cavity?
- A.
Foramen Spinosum
- B.
Stylomastoid Foramen
- C.
Foramen lacerum
- D.
Carotid Canal
- E.
Jugular Foramen
Correct Answer
A. Foramen SpinosumExplanation
Middle Meningeal Artery rupture causes epidural hematoma.Rate this question:
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- 10.
An infant has bilateral cleft lip. Which processes failed to fuse?
- A.
Lateral nasal prominences with the maxillary prominences
- B.
Maxillary prominences with the intermaxillary segments
- C.
Palatine shelves from each maxillary prominence
- D.
Medial nasal prominences from each side
- E.
Frontonasal prominence with each maxillary prominence
Correct Answer
B. Maxillary prominences with the intermaxillary segmentsExplanation
B/L cleft lipRate this question:
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- 11.
Your friend goes to a concert and comes home early complaining that the noise, which he can normally tolerate, was just too loud. On exam, you notice that he has some weakness to his muscles of facial expression. Which muscle is most likely implicated in his hyperacusis?
- A.
Mylohoid
- B.
Tensor tympani
- C.
Diagastric, Posterior Belly
- D.
Buccinator
- E.
Stapedius
Correct Answer
E. StapediusExplanation
innervated by CN VIIRate this question:
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- 12.
What bone forms the concha that overlies the meatus where the maxillary sinus drains?
- A.
Ethmoid
- B.
Nasal
- C.
Sphenoid
- D.
Vomer
- E.
None, it's cartilage
Correct Answer
A. EthmoidExplanation
: Maxillary sinus drains to middle meatus which is covered by the middle concha from the ethmoid bone.Rate this question:
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- 13.
A five year old boy is found to have a pericardial infection. Upon imaging studies the source of the infection is identified within an esophageal diverticulum. What is the route the infection spread through?
- A.
Retropharyngeal space
- B.
Vertebral bodies
- C.
Loose connective tissue of the skin
- D.
Jugular veins
- E.
Tonsillar lymphatics
Correct Answer
A. RetropHaryngeal spaceExplanation
retropharyngeal space extends from the base of the skull down to the mediastinum.Rate this question:
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- 14.
Davis, an AMSA member and second semester medical student, shadows a tonsillectomy. During the procedure, the surgeon asks the group of Ross AMSA members to name the two arches that border the Palatine Tonsils. Davis enthusiastically replies with the correct answer:
- A.
Anterior Tonsillar Arch & Posterior Tonsillar Arch
- B.
Palatoglossal Arch (Anteriorly) & Palatopharyngeal Arch (Posteriorly)
- C.
Palatopharyngeal Arch (Anteriorly) & Palatoglossal Arch (Posteriorly)
- D.
Torus Tubarius (Anteriorly) & Salpingopharyngeal fold (Posteriorly)
- E.
Palatoglossal folds (Anteriorly) & Salpingopharyngeal fold (Posteriorly)
Correct Answer
B. Palatoglossal Arch (Anteriorly) & PalatopHaryngeal Arch (Posteriorly)Explanation
The Palatoglossal Arch is anterior to the palatine tonsil and the Palatopharyngeal Arch is posterior to the palatine tonsil. Answer choice A simply doesn't exist. Answer C has incorrect spacial relationships. Answer D contains structures that are found further posterior and superior in the naso/oropharynx (See Nasal Cavity Lecture). Answer E is only half correct.Rate this question:
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- 15.
A patient has been complaining of tooth pain in his upper jaw for the past 2 weeks. Upon doing a full interview, you learn that your patient was born with a congenital condition known as situs inversus. He also has karatgener's syndrome and is infertile. He says his whole head feels heavy, his face hurts, and he has been somewhat congested as well. As a recent Ross graduate, you know that the upper row of teeth is innervated by the superior alveolar nerve, a branch of the maxillary nerve, but you recall your Anatomy Professors warning you differentiate face and tooth pain from something else. Given the history of the patient, what is he most likely suffering from?
- A.
Damage to Internal Nasal Nerve
- B.
Damage to Lesser Palatine nerve
- C.
Infection of Sphenoidal sinus
- D.
Infection of the Maxillary sinus
- E.
Damage to the Greater Palatine Nerve
Correct Answer
D. Infection of the Maxillary sinusExplanation
The history of this patient suggests that he has immotile ciliary syndrome (given his situs inversus, kartagener's and infertility). Drainage of the paranasal sinuses is also dependent on the function of cilia. Hence people with impaired ciliary function, including smokers, are more susceptible to sinusitis due to impaired drainage of the sinuses. In this case, the maxillary sinus is infected. It's proximity to the upper row of teeth (superior alveolar nerve), and the orbit (inferior orbital nerve) is noteworthy. Infection of the maxillary sinus often presents with face and tooth face.Rate this question:
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- 16.
A child is brought to the emergency room after swallowing a dime. The mother is concerned about the location of the dime. After an X-ray of the neck, the dime can be seen located in the neck. The boy has no difficulty breathing and is able to talk clearly. Which of the following is the most likely place the dime will be stuck?
- A.
Piriform Recess
- B.
Esophagus
- C.
Trachea
- D.
Vocal Cords
Correct Answer
A. Piriform RecessExplanation
the body’s piggy bank.Rate this question:
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.JPG "Matt Hasselback retaliates on Ned by punching him in the right eye. Ned suffers a blowout fracture resulting in herniation of orbital soft tissues into one of his paranasal sinuses. On the below MRI, which arrow indicates the most likely area of herniation?")
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