1.
A 3O-year-old woman visited her doctor because of a painless swelling on the right side of her neck. A CT scan revealed , a well-defined cystic mass at the angle of the mandible just anterior to the sternocleidomastoid muscle .
The MOST LIKELY diagnosis is.
Correct Answer
A. Lateral cervical cyst.
Explanation
The most likely diagnosis is a lateral cervical cyst because the patient presented with a painless swelling on the right side of her neck, and the CT scan revealed a well-defined cystic mass at the angle of the mandible just anterior to the sternocleidomastoid muscle. This location and presentation are consistent with a lateral cervical cyst, which is a common type of cyst that forms in the neck.
2.
A space of clinical importance present between the buccopharyngeal fascia anteriorly and prevertebral is known as the fascia posteriorly
Correct Answer
A. Retropharyngeal space
Explanation
The space described in the question is located between the buccopharyngeal fascia anteriorly and the prevertebral fascia posteriorly. This space is known as the retropharyngeal space. The other options mentioned in the question (supraternal space, lateral pharyngeal space, axillary space, and masticator space) do not match the description given in the question.
3.
An ENT surgeon performed tonsillectomy on 17-yearoldboy. The operation was uneventful. After a few weeks the boy complained of the loss of sensation over posterior third of the tongue. Which of the following nerves was damaged during the operation?
Correct Answer
C. Glossopharyngeal nerve
Explanation
During the tonsillectomy, the glossopharyngeal nerve was likely damaged. The glossopharyngeal nerve provides sensory innervation to the posterior third of the tongue, so its damage would result in the loss of sensation in that area. The other nerves listed do not provide sensory innervation to the posterior third of the tongue, making them less likely to be the cause of the loss of sensation.
4.
Which of the following concerning statements the embryology of the pituitary gland is CORRECT?
Correct Answer
E. Neuroectoderm gives rise to the neurohypophysis
Explanation
The correct answer is that neuroectoderm gives rise to the neurohypophysis. During embryonic development, the neurohypophysis, also known as the posterior pituitary, is derived from the neuroectoderm. The neuroectoderm forms a downgrowth from the diencephalon, which eventually gives rise to the posterior pituitary. The anterior pituitary, on the other hand, is derived from Rathke's pouch, which is an outgrowth of the oral ectoderm. Therefore, the statement that the neuroectoderm gives rise to the neurohypophysis is correct.
5.
The nerve delivering sensory innervation to the posterior side of the external ear canal is a pretrematic nerve supplying derivatives branch of the cranial of the fourth pharyngeal arch. It is the :
Correct Answer
C. Auricular nerve(of Arnold)
Explanation
The correct answer is the auricular nerve (of Arnold). This nerve is responsible for providing sensory innervation to the posterior side of the external ear canal. It is a branch of the cranial nerve of the fourth pharyngeal arch.
6.
Which of the muscles attaching to the styloid process is NOT derived from a pharyngeal arch?
Correct Answer
A. Styloglossus
Explanation
The styloglossus muscle is not derived from a pharyngeal arch. The styloglossus muscle is a muscle of the tongue, responsible for retracting and elevating the tongue. It is derived from the occipital somites, not from a pharyngeal arch. The other muscles mentioned (stylopharyngeus, stylohyoid, levator veli palatine, and tensor veli palatini) are all derived from pharyngeal arches.
7.
Which of the following statements the embryology of the pituitary gland is CORRECT?
Correct Answer
D. Oral ectoderm gives rise to the anterior pituitary
Explanation
The correct answer is that the oral ectoderm gives rise to the anterior pituitary. This means that during embryonic development, the cells that form the anterior pituitary gland originate from the oral ectoderm layer.
8.
Which of the following bones of the skull is formed by intramembranous ossification?
Correct Answer
D. Parietal
Explanation
The parietal bone of the skull is formed through intramembranous ossification. This process involves the direct ossification of mesenchymal cells without the presence of a cartilage model. The parietal bone is one of the flat bones of the skull and is formed by the ossification of membranous connective tissue. In contrast, the other options listed, such as the ethmoid, sphenoid, base of occipital, and petrous portion of temporal bones, are formed through endochondral ossification, which involves the initial formation of a cartilage model that is later replaced by bone tissue.
9.
With an infection at the tip of the tongue, which lymph node is most likely to be initially enlarged and tender?
Correct Answer
D. Sub-mental
Explanation
When there is an infection at the tip of the tongue, the lymph node that is most likely to be initially enlarged and tender is the sub-mental lymph node. The sub-mental lymph node is located under the chin and drains the tongue, floor of the mouth, and lower lip. Therefore, it is the closest lymph node to the site of infection and is likely to be the first to respond to the infection by becoming enlarged and tender.
10.
A 30-year old lady visited her dentist for the severe pain around the last lower molar tooth. The dentist examined and decided to extract the last lower tooth. Two weeks after the extraction, the lady complained of the loss of taste and general sensation over anterior two-thirds of the tongue. Which of the following structures was most likely damaged during the extraction?
Correct Answer
B. Lingual nerve
Explanation
The lingual nerve is most likely damaged during the extraction. The lingual nerve innervates the anterior two-thirds of the tongue and is responsible for taste and general sensation in that area. Therefore, damage to the lingual nerve can result in loss of taste and sensation in the anterior two-thirds of the tongue, which is consistent with the patient's symptoms.
11.
After protraction of the mandible, it is retracted by which of the following muscles fibers?
Correct Answer
D. Posterior fibers of the temporalis
Explanation
After protraction of the mandible, the posterior fibers of the temporalis muscle are responsible for retracting it. The temporalis muscle is a powerful muscle that is involved in the movement of the mandible. The posterior fibers specifically help to pull the mandible back towards its original position after it has been pushed forward. This muscle plays an important role in chewing and biting movements.
12.
An ENT surgeon performed the tonsillectomy on a 15-yearold boy. After the operation, the surgeon noticed severe bleeding from the tonsillar bed. Which of the following arteries is responsible for this bleeding?
Correct Answer
C. A branch of the facial artery
13.
A 12-year-old female who underwent a tonsillectomy a week previously complains to her physician that the back of her tongue “feels numb." What nerve was most likely damaged in the surgery?
Correct Answer
C. CN IX
Explanation
During a tonsillectomy, the surgeon may inadvertently damage the glossopharyngeal nerve (CN IX), which innervates the back of the tongue. This can result in numbness or loss of sensation in the affected area. The other nerves listed, such as the chorda tympani, CN V3, CN X, and internal laryngeal nerve, do not primarily innervate the back of the tongue, making CN IX the most likely nerve to be damaged in this scenario.
14.
The cricothyroid muscle is the only laryngeal muscle innervated by the external laryngeal nerve. This muscle moves which joint?
Correct Answer
C. Cricothyroid joint
Explanation
The correct answer is cricothyroid joint. The cricothyroid muscle is innervated by the external laryngeal nerve and is responsible for controlling the tension of the vocal cords. It helps to adjust the pitch and tension of the vocal cords by moving the cricothyroid joint, which is located between the cricoid cartilage and the thyroid cartilage in the larynx. The other joints listed (cricoarytenoid joint, cricotracheal joint, sternoclavicular joint, and acromioclavicular joint) are not involved in the movement of the cricothyroid muscle.
15.
An emergency rescue technician attempts to place an emergency airway in a patient who has sustained facial injuries in a motor vehicle accident. He locates the thyroid cartilage and then inserts n intubation tube into the thyrohyoid membrane, rather than the cricothyroid membrane. Which structure was NOT at risk of injury by this incorrect placement of the tube?
Correct Answer
D. Thyroid ima artery
Explanation
The incorrect placement of the intubation tube into the thyrohyoid membrane instead of the cricothyroid membrane would not put the thyroid ima artery at risk of injury. The thyroid ima artery is a rare anatomical variation that is not present in all individuals. It arises from the brachiocephalic trunk or the arch of the aorta and supplies blood to the thyroid gland. Since it is not a structure that is commonly found, it would not be at risk of injury in this scenario.
16.
A 22-year-old woman presents to her physician with a neck swelling. She said the swelling started growing suddenly for past 1 week and it started to hurt and she can't breathe. On Inspection the physician identified it as a solitary swelling which moved up on deglutition. On palpation he found the swelling was firm in consistency and it was not attached to the skin. The following statements concerning this swelling would LEAST LIKELY suggest a diagnosis of the thyroid gland swelling?
Correct Answer
B. The swelling is located superficial to the sternothyroid muscle
Explanation
The statement that the swelling is located superficial to the sternothyroid muscle would least likely suggest a diagnosis of thyroid gland swelling because the thyroid gland is located deep to the sternothyroid muscle. Therefore, if the swelling is superficial to this muscle, it is unlikely to be related to the thyroid gland.
17.
An incision has to be made on which membrane in an allergic glottis edema?
Correct Answer
C. Median cricothyroid ligament
Explanation
The correct answer is the median cricothyroid ligament. In an allergic glottis edema, an incision needs to be made on the median cricothyroid ligament to relieve the swelling and open up the airway. This ligament connects the cricoid cartilage to the thyroid cartilage and is located in the front of the neck. By making an incision on this ligament, it allows for better airflow and can help alleviate the symptoms of the allergic reaction.
18.
A patient has hoarse voice after a thyroid surgery. It is most probably caused by:
Correct Answer
D. Lesion of the recurrent laryngeal nerve
Explanation
After a thyroid surgery, a patient may experience a hoarse voice due to a lesion of the recurrent laryngeal nerve. The recurrent laryngeal nerve controls the movement of the vocal cords, and any damage to this nerve can result in vocal cord paralysis or weakness, leading to hoarseness. This is a common complication of thyroid surgery, as the recurrent laryngeal nerve is in close proximity to the thyroid gland and can be accidentally injured during the procedure. The other options, such as chronic glottis edema, compression of the trachea, removal of the parathyroid glands, or lesion of the inferior laryngeal artery, are less likely to cause hoarseness in this scenario.
19.
A four-year-old child is brought into the Emergency room with a foreign object embedded in her throat. Examination reveals that it is an open safety pin lodged deeply in the left piriform fossa of the laryngopharynx. The physician is able to remove the safety pin under general anesthetic. After the procedure a laryngoscopy reveals that the left vocal fold is flaccid and the girl has trouble speaking in her normal voice. What nerve was damaged?
Correct Answer
A. Inferior laryngeal nerve
Explanation
The inferior laryngeal nerve is responsible for innervating the muscles of the larynx, including the vocal folds. Damage to this nerve can result in paralysis or weakness of the vocal folds, leading to difficulty speaking in a normal voice.
20.
A 50-year old man has a partial thyroidectomy for a tumor. During the operation the internal laryngeal nerve was damaged. Which of the following area will lose the general sensation?
Correct Answer
C. Larynx above the vocal cord
Explanation
Damage to the internal laryngeal nerve during a partial thyroidectomy would result in loss of general sensation in the larynx above the vocal cord. The internal laryngeal nerve provides sensory innervation to the mucosa of the larynx above the vocal cord, including the epiglottis, aryepiglottic folds, and false vocal cords. Therefore, the other options (over the epiglottis only, larynx below the vocal cord, ventricle of the larynx only, saccule of the larynx only) are incorrect as they do not involve the specific area innervated by the internal laryngeal nerve.