Head and neck

  1. Damage to the external laryngeal nerve during thyroid surgery could result in the inability to

(A)Relax the vocal cords

(B)Rotate the arytenoid cartilages

(C)Tense the vocal cords

(D)Widen the rima glottidis

(E)Abduct the vocal cords

  1. On ligation of the superior laryngeal artery ,care must be taken to avoid injury to which of the following nerves?

(A)External laryngeal nerve

(B)Internal laryngeal nerve

(C)Superior laryngeal nerve

(D)Hypoglossal nerve

(E)Vagus nerve

  1. In a patient who demonstrates a lack of general sensation in the nasopharynx

,a lesion of which of following nerves would be expected?

(A)Maxillary nerve

(B)Superior cervical ganglion

(C)External laryngeal nerve

(D)Glossopharyngeal nerve

(E)Vagus nerve

  1. During surgery ,a surgeon notices profuse bleeding from the deep cervical artery,which of the following arteries must be ligated immediately?

(A)Inferior thyroid artery

(B)Transverse cervical artery

(C)Thyrocervical trunk

(D)Costocervical trunk

(E)Ascending cervical artery

  1. The phrenic nerve passes by which of the following structures in the neck?

(A)Anterior to the subclavian vein

(B)Posterior to the subclavian artery

(C)Deep to the anterior scalene muscle

(D)Medial to the common carotid artery

(E)Superficial to the anterior scalene muscle

  1. Which of the following muscles is a landmark for locating the glossopharyngeal

Nerve in the neck?

(A)Inferior pharyngeal constrictor muscle

(B)Stylopharyngeus muscle

(C)Posterior belly of the digastric muscle

(D)Longus colli muscle

(E)Rectus capitis anterior muscle

7.A lesion of the external laryngeal branch of the superior laryngeal nerve may cause weakness of which of following muscles?

(A)Inferior pharyngeal constrictor muscle

(B)Middle pharyngeal constrictor muscle

(C)Superior pharyngeal constrictor muscle

(D)Thyroarytenoid muscle

(E)Thyrohyoid muscle

8.A patient with crocodile tears syndrome has spontaneous lacrimation during due to misdirection of regenerating autonomic nerve fibers .which of the following nerves has been injured?

(A)Facial nerve proximal to the geniculate ganglion

(B)Auriculotemporal nerve

(C)Chorda tympani in the infratemporal fossa

(D)Facial nerve at the stylomastoid foramen

(E)Lacrimal nerve

9.A 13-year-old girl complains of dryness of the nose and the palate,indicating a lesion of which of the following ganglia?

(A)Nodose ganglia

(B)otic ganglia

(C)Pterygopalating ganglia

(D)submandibular ganglia

(E)Ciliary ganglia

10.Bell’spalsy can involve corneal inflammation and subsequent corneal ulceration ,which results from

(A)sensory loss of the cornea and conjunctiva

(B)lack of secretion of the salivary glands

(C)absence of the corneal blink reflex due to paralysis of the muscles that close the eyelid

(D)absence of the corneal blink reflex due to paralysis of the muscles that open the eyelid

(E)constriction of the pupil due to paralysis of the dilator pupillae

11.which of the following sinuses lies in the margin of the tentorium cerebelli,running from the posterior end of the cavernous sinus to the transverse sinus?

(A)Straight sinuses

(B)Inferior sagittal sinuses

(C)Sphenoparietal sinuses

(D)Superior petrosalsinuses

(E)Cavernous sinuses

12.Which of the following condition results from severance of the abducens nerve

Proximal to its entrance into the orbit?

(A)Ptosis of the upper eyelid

(B)Loss of the ability to dilate the pupil

(C)External strabismus (lateral deviation)

(D)Loss of visual accommodation

(E)Internal strabismus (medial deviation)

13.Death may result from bilateral severance of which of the following nerves?

(A)trigeminal nerve

(B)Facial nerve

(C)Vagus nerve

(D)Spinal accessory nerve

(E)Hypoglossal nerve

14.When the middle meningeal artery is ruptured but the meninges intagt.blood enters which of the following spaces?

(A)Subarachnoid space

(B)Subdural space

(C)Epidural space

(D)Subpial space

(E)Cranial dural sinuses

15.which of the following structures contains cell bodies of preganglionic parasympathetic neurons?

(A)Cervical and sacral spinal cord

(B)Cervical and thoracic spinal cord

(C)Brainstem and cervical spinal cord

(D)Thoracic and lumbar spinal cord

(E)Brainstem and sacral spinal cord

16.Following radical resection of a primary tongue tumor,a patient has lost general sensation on the anterior two-thirds of the tongue ,which of the following nerves?

(A)trigeminal nerve

(B)Facial nerve

(C)Glossopharyngeal nerve

(D)Vagus nerve

(E)Hypoglossal nerve

17.The pituitary gland lies in the sella tureica immediately posterior and superior to which of the following structures?

(A)Frontal sinus

(B)Maxillary sinus

(C)Ethmoid air cells

(D)Mastoid air cells

(E)Sphenoid sinus

18.After tonsillectomy ,a-year-boy is unable to distinguish the sensation of taste on the posterior one-third of his tongue.Which of the following nerves most likely has been injured?

(A)Internal laryngeal nerve

(B)Lingual nerve

(C)Lingual branch of the glossopharyngeal nerve

(D)Greater palatine nerve

(E)Chorda tympani

19. Damage to the sella turcica is probably due to fracture of which of the following bones?

(A)frontal bone

(B)Ethmoid bone

(C)Temporal bone

(D)Basioccipital bone

(E)Sphenoid bone

20.The scalenus anterior muscle

(A)inserts on the second rib

(B)is innervated by the phrenic nerve

(C)passes anterior to the subclavian vein

(D)descends posterior to the subclavian artery

(E)runs anterior to the root of the brachial plexus

21.A patient has an infectious inflammation of the dural venous sinus nearest to the pituitary gland ,with secondary thrombus formation .Which of the following is the most likely site of infection?

(A)Straight sinus

(B)Cavernous sinus

(C)Superior petrosal sinus

(D)Sigmoid sinus

(E)Confluence of sinuses

22.A patient with a pituitary tumor would exhibit which of the following disorders?

(A)Blindness

(B)Bitemporal (heteronymous )hemianopia

(C)Right nasal hemianopia

(D)Left homonymous hemianopia

(E)Binasal hemianopia

23.If a patient is unable to abduct the vocal cords during quiet breathing , which of the following muscles is paralyzed?

(A)Vocalis muscle

(B)Cricothyroid muscle

(C)Oblique arytenoid muscle

(D)Posterior cricoarytenoid muscle

(E)Thyroarytenoid muscle

24.Which of the following pairs of muscles is most instrumental in preventing food from entering the larynx and trachea during swallowing?

(A)Sternohyoid and sternothyroid muscles

(B)Oblique arytenoid and aryepiglottic muscles

(C)Inferior pharyngeal constrictor and thyrohyoid muscles

(D)Levator veli palatini and tensor veli palatini muscles

(E)Musculus uvulae and geniohyoid muscles

25.The veins of the brain are direct tributaries of the

(A)emissary veins

(B)pterygoid venous plexus

(C)diploic veins

(D)dural venous sinuses

(E)internal jugular vein

26.Which of the following conditions or actions results from stimulation of the parasympathetic fibers to the eyeball?

(A)Enhanced vision for distant objects

(B)Dilation of the pupil

(C)Contraction of capillaries in the iris

(D)Contraction of the ciliary muscle

(E)Flattening of the lens

27.The tympanic nerve

(A)is a branch of the facial nerve

(B)contains postganglionic parasympathetic fibers

(C)synapses with fibers in the lesser petrosal nerve

(D)is a branch of the glossopharyngeal nerve

(E)forms the tympanic plexus in the external auditory meatus

28.Which of the following cavities are separated from the middle cranial fossa by a thin layer of bone?

(A)Auditory tube and bony orbit

(B)Middle ear cavity and sphenoid sinus

(C)Sigmoid sinus and frontal sinus

(D)Sphenoid sinus and ethmoid sinus

(E)Maxillary sinus and middle ear cavity

29.Loss of general sensation in the dura of the middle cranial fossa indicates a lesion of the

(A)vagus nerve

(B)facial nerve

(C)hypoglossal nerve

(D)trigeminal nerve

(E)glossopharyngeal nerve

30.The carotid sinus

(A)is located at the origin of the external carotid artery

(B)is innervated by the facial nerve

(C)functions as a chemoreceptor

(D)is stimulated by changes in blood pressures

(E)communicates freely with the cavernous sinus

31.During a game ,a 26-year-old baseball player receives a severe blow to the head that fractures the optic canal.Which of the following pairs of structures is most likely to be damaged?

(A)Optic nerve and ophthalmic vein

(B)Ophthalmic vein and ophthalmic nerve

(C)Ophthalmic artery and optic nerve

(D)Ophthalmic nerve and optic nerve

(E)Ophthalmic artery and ophthalmic vein

32.Paralysis of the posterior belly of the digastric muscle would result from a lesion of which of the following nerve?

(A)Accessory nerve

(B)Trigeminal nerve

(C)Ansa cervicalis

(D)Facil nerve

(E)Glossopharyngeal nerve

33.Contraction of the tensor tympani and the stapedius prevents damage to the eardrum and middle ear ossicles.These muscles are most likely controlled by which of the following nerves?

(A)Chorda tympani and tympanic nerve

(B)Trigeminal and facial nerve

(C)Auditory and vagus nerve

(D)Facial and auditory nerve

(E)Trigeminal and Accessory nerve

34.If a patient’s pupil remains small when room lighting is subdued,which of the following nerve would be injured?

(A)Trochlear nerve

(B)Superior cervical ganglion

(C)Oculomotor nerve

(D)Ophthalmic nerve

(E)Abducens nerve

35.Which of the following statements concerning the frontal sinus is correct?

(A)It extends into the parietal bone

(B)It communicates with the superior nasal meatus

(C)It receives sensory innervation from the maxillary nerve

(D) It is supplied with blood by branches of the ophthalmic artery

(E)It is a cranial dural venous sinus that receivesthe ophthalmic vein

36.Apatient can move his eyeball normally and see distant objects clearly but cannot focus on near objects .This condition may indicate damage to the

(A)ciliary ganglion and oculomotor nerve

(B)oculomotor nerve and long ciliary nerve

(C)short ciliary nerve and ciliary ganglion

(D)superior cervical ganglion and long ciliary nerve

(E)oculomotor.trochlear ,and abducens nerve

37.Which of the following structures enters the orbit through the superior orbital fissure and the common tendinous ring?

(A)Frontal nerve

(B)Lacrimal nerve

(C)Trochlear nerve

(D)Abducens nerve

(E)Ophthalmic vein

38.Which of the following groups cranial nerves is damaged if the muscles attached to the styloid process are paralyzed?

(A)Facial ,glosssopharyngeal,and hypoglossal nerve

(B)Hypoglossal ,vagus,and facial nerve

(C)Glosssopharyngeal,trigeminal,and vagus nerve

(D)Vagus ,spinal accessory ,and hypoglossal nerve

(E)Facial .glosssopharyngeal,and vagus nerve

39.A 32-yare-old woman has hoarseness in her voice ,and her uvula is deviated to the left upon phonation, Which of the following nerve is danaged?

(A)Right trigeminal nerve

(B)Left trigeminal nerve

(C)Right vagus nerve

(D)Left vagus nerve

(E)Left glosssopharyngeal nerve

40.When a low tracheotomy is performed below the isthmus of the thyroid ,which of the following vessels may be encountered?

(A)Inferior thyroid artery

(B)Inferior thyroid vein

(C)Costocervical trunk

(D)Superior thyroid artery

(E)Right brachiocephalic vein

41.If a patient has no cutaneous sensation on the anterior cervical triangle,it is likely that damage has occurred to which of the following nerves?

(A)Phrenic nerve

(B)Greater auricular nerve

(C)Transverse cervical nerve

(D)Supraclavical nerve

(E)Lsser occipital nerve

42.In a patient with swelling of the mucous membranes of the supperior nasal meatus,which of the openings of the paranasal sinuses are plugged?

(A)Middle ethmoidal sinus

(B)Maxillary sinus

(C)Posterior ethmoidal sinus

(D)Anterior ethmoidal sinus

(E)Frontal sinus

43.The tongue of a 45-year-old patient deviates to the left on protrusion.Which of the following nerves is injured?

(A)Right lingual nerve

(B)Left lingual nerve

(C)Right hypoglossal nerve

(D)Left hypoglossal nerve

(E)Left glosssopharyngeal nerve

44.Which condition would most likely result in a patient’s inability to move the his right eye laterally?

(A)A tumor of the pituitary gland

(B)Occlusion of the right posterior cerebral artery

(C)An infection in the right maxillary sinus

(D)An infection in the right cavernous sinus

(E)A tumor in the right anterior cranial fossa

45.If the lingual nerve is damaged as it enters the oral cavity ,which of the following structures contain cell bodies of injured nerve fibers?

(A)Geniculate and otic ganglia

(B)Trigeminal and submandibular ganglia

(C)Trigeminal and dorsal root ganglia

(D)Geniculate and trigeminal ganglia

(E)Geniculate and pterygopalatine ganglia

46.A tumor located in the optic canal would most likely damage which of the following structures?

(A)Ophthalmic vein

(B)Ophthalmic nerve

(C)Oculomotor nerve

(D)Trochlear nerve

(E)Ophthalmic artery

47.A horizontal cut through the cricothyroid ligament in the neck would sever which of the following structures?

(A)Inferior laryngeal nerve

(B)External carotid arteries

(C)Inferior thyroid vein

(D)Thyrocervical trunks

(E)Internal laryngeal nerve

48.Severance of the oculomotor nerve can cause which of the following condition ?

(A)Complete ptosis

(B)Abduction of the eyeball

(C)A constricted pupil

(D)Impaired lacrimal secretion

(E)Paralysis of the ciliary muscle

49.Which of the following nerve supply striated muscles and are of branchiomeric origin?

(A)Oculomotor nerves

(B)Trochlear nerves

(C)Trigeminal nerves

(D)Abducens nerves

(E)Hypoglossal nerves

50.During surgery for malignant parotid tumors,the main trunk of the facial nerve is lacerated ,resulting in paralysis of which of the following muscles?

(A)Masseter muscle

(B)Stylopharyngeus muscle

(C)Anterior belly of the digastric muscle

(D)Buccinator muscle

(E)Tensor tympani

51.During gang fighting ,the nasal septum of a 17-year-old boy injured by a fist ,which of the following structures would be damaged?

(A)Septal cartilage and nasal bone

(B)Inferior concha and vomer

(C)Vomer and perpendicular plate of ethmoid

(D)Septal cartilage and middle concha

(E)Cribriform plate and incisive foramen

52.The tensor tympani

(A)inserts on the long process of the incus

(B)is innervated by a branch of the facial nerve

(C)runs parallel to the external acoustic meatus

(D)arises chiefly from the tympanic membrane

(E)functions to tighten the tympanic membrane

53.Infection within the carotid sheath may damage which of the following structures?

(A)Vagus nerve and middle cervical ganglion

(B)Common carotid artery and recurrent laryngeal nerve

(C)Internal jugular vein and vagus nerve

(D)Sympathetic trunk and common carotid artery

(E)External carotid artery and ansa cervicalis

54.An occlusion of the costocervical trunk could produce a marked decrease in the blood flow in which of the following arteries?

(A)Superior thoracic artery

(B)Transverse cervical artery

(C)Ascending cervical artery

(D)Deep cervical artery

(E)Inferior thyroid artery

55.The internal laryngeal nerve

(A)is a branch of the superior laryngeal nerve

(B)may contain taste fibers from the palate

(C)provides sensory innervation to the laryngeal mucosa below the vocal cord

(D)provides motor innervation to the cricothyroid muscle

(E)is accompanied by the superior thyroid artery

56.Which of the following nerve would be spared from infection in the cavernous sinus?

(A)Oculomotor nerves

(B)Abducens nerves

(C)Trochlear nerves

(D)Mandibular nerves

(E)Ophthalmic nerves

57.Which of the following tonsils is called the adenoid when enlarged?

(A)Palatine tonsil

(B)Pharyngeal tonsil

(C)Tubal tonsil

(D)Lingual tonsil

(E)Eustachian tonsil

58.An eroded lesion in the jugular foramen may damage which of the following pairs of structures?

(A)Vagus nerve and internal carotid artery

(B)Accessory nerve and external jugular vein

(C)Internal jugular vein and hypoglossal nerves

(D)Glossopharyngeal and vagus nerve

(E)Hypoglossal and spinal accessory nerves

59.A 12-year-old girl is unable to close her lips .Which of the following muscles is paralyzed?

(A)Levator labii superioris

(B)Zygomaticus minor

(C)Orbicularis oris

(D)Lateral pterygoid

(E)Depressor labii superioris

60.Severance of the greater petrosal nerve would produce which of the following conditions?

(A)Increased lacrimal gland secretion

(B)Loss of taste sensation in the epiglottis

(C)Dryness in the nose and palate

(D)Decreased parotid gland secretion

(E)Loss of general visceral sensation in the pharynx

61.A benign tumor in the pterygoid canal could injure which of the following nerve fibers?

(A)Postganglionic parasympathetic fibers

(B)Taste fiber from the epiglottis

(C)General somatic afferent (GSA) fibers

(D)Preganglionic sympathetic fibers

(E)General visceral afferent(GVA) fibers

62.The pupillary light reflex can be eliminated by cutting which of the following nerve?

(A)Short ciliary,ophthalmic,and oculomotor nerves

(B)Long ciliary,optic ,and short ciliary nerves

(C)Oculomotor,short ciliary,and optic nerves

(D)Optic and long ciliary nerves ,ciliary ganglion

(E)Ophthalmic and optic nerves,ciliary ganglion

63.A 22-year-old patient has a dry corneal surface due to a lack of moistening fluid .Which of the following nerves is damaged?

(A)Proximal portion of the lacrimal nerve

(B)Zygomatic branch of the facial nerve

(C)Lesser petrosal nerve

(D)Greater petrosal nerve

(E)Deep petrosal nerve

64.Which of the following statements concerning the tongue is correct?

(A)The palatoglossus muscles are innervated by the hypoglossal nerves

(B)Taste buds in the vallate papillae are innervated by the chorda tympani of the facial nerve

(C)Its anterior two-thirds receives general sensory innervation from the facial nerve

(D)It receives taste fibers from the facial and glossopharyngeal nerves

(E)It is retracted by the genioglossus

65.A patient has a functional impediment and cannot perform the act of swallowing .Which of the following nerves is functioning normally

(A)Hypoglossal nerve

(B)Spinal accessory nerve

(C)Vagus nerve

(D)Facial nerve

(E)Trigeminal nerve

66.Which of the following muscles would most likely open the jaw?

(A)Masseter muscle

(B)Medial pterygoid muscle

(C)Lateral pterygoid muscle

(D)Buccinator muscle

(E)Temporalis muscle

67.Which of the following muscles would most likely open the eye?

(A)Orbicularis oculi

(B)Orbicularis oris

(C)Frontalis

(D)Levator palpebrae superioris

(E)Superior rectus

68.Fracture of the foramen rotundum would cause a lesion of which of the following nerve?

(A)Ophthalmic nerve

(B)Optic nerve

(C)Maxillary nerve

(D)Mandibular nerve

(E)Trochlear nerve

69.A lack of salivary secretion from the submandibular gland may indicate a lesion of which of the following nervous structures?

(A)Lingual nerve at its origin

(B)Chorda tympani in the middle ear cavity

(C)Superior cervical ganglion

(D)Lesser petrosal nerve

(E)Auriculotemporal nerve

70.Lack of accommodation results from paralysis of which of the following muscles?

(A)Tarsal muscle

(B)Sphincter pupillae