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WorksheetsHead and Neck day 1
Total questions: 102
Worksheet time: 51mins
A 17-year-old female was admitted to the hospital with a high fever. Following intravenous administration of antibiotics, a routine CT scan revealed features consistent with thoracic outlet syndrome. Which symptom would most likely result from this syndrome?
Problems with respiration because of pressure on the phrenic nerve
Reduced blood flow to the thoracic wall
Reduced venous return from the head and neck
Numbness in the upper limb
Distention of the internal jugular vein
A 40-year-old unconscious man is admitted to the emergency department after being hit in the head with a baseball. A CT scan examination reveals a fractured pterion and an epidural hematoma. Branches of which of the following arteries are most likely to be injured?
External carotid
Superficial temporal
Maxillary
Deep temporal
Middle meningeal
A 31-year-old female is admitted to the hospital after an automobile collision. A CT scan examination reveals a large hematoma inferior to the right jugular foramen. Physical examination reveals right pupillary constriction (miosis) and anhidrosis (loss of sweating) of the face. Which of the following ganglia is most likely affected by the hematoma?
Submandibular
Trigeminal (semilunar or Gasserian)
Superior cervical
Geniculate
Ciliary
An unconscious 48-year-old woman is admitted to the hospital. CT scan reveals a tumor in her brain. When she regains consciousness, her right eye is directed laterally and downward, with complete ptosis of her upper eyelid, and her pupil is dilated. Which of the following structures was most likely affected by the tumor to result in these symptoms?
Oculomotor nerve
Optic nerve
Facial nerve
Ciliary ganglion
Superior cervical ganglion
A 35-year-old male patient is admitted to the hospital with severe headaches. A CT scan evaluation reveals a tumor in the infratemporal fossa. Physical examination reveals loss of general sensation from the anterior two-thirds of his tongue, but taste and salivation are intact. Which of the following nerves is most likely affected by the tumor?
Lingual nerve proximal to its junction with the chorda tympani
Chorda tympani
Inferior alveolar
Lesser petrosal
Glossopharyngeal
A 55-year-old man is admitted to the hospital after an injury sustained at work in a factory. He presents with severe scalp lacerations, which were sutured. After three days the wound is inflamed, swollen, and painful. Between which tissue layers is the infection most likely located?
The periosteum and bone
The aponeurosis and the periosteum
The dense connective tissue and the aponeurosis
The dense connective tissue and the skin
The dermis and the epidermis
A 36-year-old woman is admitted to the hospital with severe head injuries after a car crash. During neurologic examination, her uvula is deviated to the right. Which nerve is most likely affected to result in this deviation?
Left vagus
Right vagus
Right hypoglossal
Left glossopharyngeal
Right glossopharyngeal
A 7-year-old boy with a high fever is brought to the pediatrician. During physical examination the patient complains of pain in his ear. His throat appears red and inflamed, confirming the diagnosis of pharyngitis. Which of the following structures provided a pathway for the infection to spread to the tympanic cavity (middle ear)?
Choanae
Internal acoustic meatus
External acoustic meatus
Pharyngotympanic tube
Pharyngeal recess
A 33-year-old woman is unconscious when she is admitted to the hospital after she fell, hitting her head. The physician in the emergency department performs a pupillary light reflex test. The integrity of which of the following nerves is being checked?
Optic and facial
Optic and oculomotor
Maxillary and facial
Ophthalmic and oculomotor
Ophthalmic and facial
A 22-year-old male is admitted to the emergency department and intubated. An endotracheal tube is passed through an opening between the vocal folds. What is the name of this opening?
Piriform recess
Vestibule
Ventricle
Vallecula
Rima glottidis
A 48-year-old male patient complains of diplopia (double vision). On neurologic examination he is unable to adduct his left eye and lacks a corneal reflex on the left side. Where is the most likely location of the lesion resulting in the symptoms?
Inferior orbital fissure
Optic canal
Superior orbital fissure
Foramen rotundum
Foramen ovale
A 34-year-old male complains of hyperacusis (sensitivity to loud sounds). Injury to which of the following cranial nerves is responsible?
Trigeminal nerve
Facial nerve
Vestibulocochlear nerve
Glossopharyngeal nerve
Vagus nerve
A 55-year-old male has a complaint of left-sided maxillary tooth pain. A dental examination reveals no abnormalities of his teeth. During physical examination tapping on his right maxilla elicits sharp pain on the right side of his face. The patient reports that he has no allergies. Which of the following conditions will be the most likely diagnosis?
Sphenoid sinusitis
Anterior ethmoidal sinusitis
Posterior ethmoidal sinusitis
Maxillary sinusitis
Frontal sinusitis
A 70-year-old man is admitted to the hospital with severe headaches. During physical examination he has difficulty coughing and swallowing. A CT scan shows a tumor affecting a cranial nerve. Which nerve is most likely affected?
Hypoglossal
Facial
Accessory
Vagus
Glossopharyngeal
A 34-year-old swimmer presents to your office with an external ear canal infection (otitis externa). The patient coughs during inspection of the external auditory meatus with a speculum. The cough results from the irritation of which nerve that innervates an area of the external auditory meatus?
Vestibulocochlear
Vagus
Trigeminal
Facial
Accessory
A 29-year-old woman underwent a thyroidectomy. Postoperatively, the patient presented with hoarseness. Which of the following nerves was most likely injured during the operation?
Internal laryngeal
External laryngeal
Recurrent laryngeal
Superior laryngeal
Glossopharyngeal
A 48-year-old man presents with a constricted right pupil that does not react to light. His left pupil and vision in both eyes are normal. These findings are most likely due to a lesion involving which of the following right-sided structures?
Oculomotor nerve
Superior cervical ganglion
Nervus intermedius
Edinger-Westphal nucleus
A 55-year-old woman is diagnosed with a tumor at the base of the skull, resulting in a decrease in tear production. Which of the following nerves is most likely injured?
Chorda tympani
Deep petrosal
Greater petrosal
Lesser petrosal
Nasociliary
A 45-year-old woman is admitted to the hospital for severe ear pain. Physical examination reveals chronic infection of the mastoid air cells (mastoiditis). The infection can erode the thin layer of the bone between the mastoid air cells and the posterior cranial fossa and spread most commonly into which of the following venous structures?
Superior sagittal sinus
Inferior sagittal sinus
Straight sinus
Cavernous sinus
Sigmoid sinus
A 24-year-old man is admitted to the hospital after a street fight. Radiographic examination reveals an inferior (blow-out) fracture of the orbit. Orbital structures would most likely be found inferiorly in which of the following spaces?
Ethmoidal sinus
Frontal sinus
Maxillary sinus
Nasal cavity
Sphenoidal sinus
A patient suffers a fracture involving the medial wall of the orbit. This injury most commonly causes herniation of orbital contents into which adjacent air-filled sinus?
Frontal sinus
Sphenoid sinus
Maxillary sinus
Ethmoidal air cells
The Oculomotor Nerve (CN III) supplies four extrinsic eye muscles. The one muscle that wraps around the trochlea to change its pull direction, allowing the eye to look down and out, is supplied by which different cranial nerve?
CN I
CN IV
CN VI
CN VII
A lesion affecting the Abducens Nerve (CN VI) will cause the eye to deviate medially (cross-eyed) because of the unopposed action of which muscle?
Superior rectus
Inferior oblique
Medial rectus
Lateral rectus
The Trigeminal Nerve (CN V) has three major divisions. Which division carries the secretomotor fibers for the lacrimal gland before they eventually join the lacrimal nerve?
Ophthalmic (V1)
Maxillary (V2)
Mandibular (V3)
Facial (CN VII)
The Superior Orbital Fissure transmits several crucial structures. Which is the only structure that passes outside the common tendinous ring to enter the orbit?
Nasociliary nerve
Oculomotor nerve (superior division)
Abducens nerve
Lacrimal nerve
The Corneal Reflex involves the afferent limb (touch sensation) and the efferent limb (motor response). The efferent component causing closure of the eyelids is supplied by which nerve?
CN V3
CN V1
CN VII
CN III
A small branch of the Facial Nerve (CN VII) carries taste fibers from the anterior two-thirds of the tongue. This nerve branch is the:
Greater petrosal nerve
Nerve to stapedius
Chorda tympani
Lingual nerve
The Optic Nerve (CN II) is developmentally a protrusion of the diencephalon and is sheathed by meninges. The only blood vessel supplying the retina that runs within the optic nerve is the:
Superior ophthalmic vein
Central retinal artery
Inferior ophthalmic artery
Ciliary artery
Parasympathetic fibers traveling with the Oculomotor Nerve (CN III) synapse in the Ciliary Ganglion. Postganglionic fibers then supply which muscle?
Dilator pupillae
Superior tarsal muscle
Sphincter pupillae
Superior oblique
Which cranial nerve exits the brainstem dorsally before winding around the midbrain to enter the orbit?
Oculomotor nerve
Abducens nerve
Trochlear nerve
Trigeminal nerve
The Cavernous Sinus is traversed by several nerves. Which cranial nerve runs within the lateral wall of the sinus and lies most superiorly?
CN III
CN IV
CN V1
CN VI
Ptosis can occur due to damage to the sympathetic supply of which muscle?
Orbicularis oculi
Levator palpebrae superioris
Superior tarsal muscle
Frontalis muscle
The pupillary light reflex involves which midbrain nucleus for central integration?
Red nucleus
Substantia nigra
Pretectal nucleus
Inferior colliculus
The Lingual Nerve carries general sensation from the anterior two-thirds of the tongue and is joined by which nerve carrying taste fibers?
Hypoglossal nerve
Glossopharyngeal nerve
Chorda tympani
Auriculotemporal nerve
Which branch of the mandibular nerve contains both sensory fibers to the cheek and motor fibers to the buccinator muscle?
Auriculotemporal nerve
Lingual nerve
Inferior alveolar nerve
Buccal nerve
Which muscle opens the pharyngotympanic tube during swallowing?
Tensor tympani
Stapedius
Tensor veli palatini
Levator veli palatini
Sensation of the external surface of the tympanic membrane is supplied by auriculotemporal nerve and which other nerve?
CN V1
CN III
CN IX
CN X
Tensor tympani is supplied by which nerve?
CN VII
CN V3
CN IX
CN X
Stapedius muscle is supplied by which nerve?
CN IX
CN V3
CN VII
CN X
The promontory of the middle ear is formed by which structure?
Lateral semicircular canal
Utricle
Basal turn of cochlea
Vestibule
Facial nerve supplies which middle ear muscle?
Tensor tympani
Stapedius
Tensor veli palatini
Salpingopharyngeus
Fluid in scala vestibuli and scala tympani is called:
Endolymph
Intralymph
Perilymph
Aqualymph
Chorda tympani passes between which ossicles?
Incus and stapes
Malleus and incus
Malleus and stapes
Stapes and promontory
Mastoid air cells communicate with middle ear via:
Round window
Oval window
Aditus to mastoid antrum
Tympanic canal
Linear acceleration is detected by receptors in:
Semicircular canals
Cochlea
Utricle and saccule
Scala media
Deepest sensation of external auditory canal is supplied by:
Auriculotemporal nerve
Great auricular nerve
Vagus nerve
Facial nerve
Structure lying inferior to middle ear cavity:
Internal carotid artery
External carotid artery
Internal jugular vein
Transverse sinus
Round window is closed by:
Basilar membrane
Tectorial membrane
Secondary tympanic membrane
Tympanic membrane
Otic ganglion supplies which gland?
Lacrimal
Sublingual
Parotid
Submandibular
Epitympanic recess lies above which ossicle?
Stapes
Incus
Malleus
Lenticular process
Taste buds innervated by CN IX are present in:
Filiform papillae
Fungiform papillae
Foliate papillae
Circumvallate papillae
Posterior epistaxis commonly involves which artery?
Anterior ethmoidal
Posterior ethmoidal
Greater palatine
Sphenopalatine
Which artery does not contribute to Kiesselbach plexus?
Anterior ethmoidal
Superior labial
Greater palatine
Posterior ethmoidal
Which tongue muscle is supplied by vagus nerve?
Genioglossus
Hyoglossus
Styloglossus
Palatoglossus
Olfactory nerve passes through:
Sphenoid
Vomer
Ethmoid
Nasal bone
Afferent limb of gag reflex is:
CN X
CN V2
CN VII
CN IX
Pharyngeal constrictors insert into:
Hyoid bone
Thyroid cartilage
Pharyngeal raphe
Cricothyroid membrane
Foreign body in piriform recess endangers:
Recurrent laryngeal nerve
External laryngeal nerve
Internal laryngeal nerve
Vagus nerve
Lymph from tip of tongue drains to:
Upper deep cervical
Retropharyngeal
Submental
Pretracheal
Tonsil in nasopharynx:
Palatine
Lingual
Tubal
Pharyngeal
Tonsil at base of tongue:
Pharyngeal
Palatine
Lingual
Tubal
Hypoglossal nerve crosses superficial to:
Facial artery
Lingual artery
Superior thyroid artery
Occipital artery
Pterygoid venous plexus connects to cavernous sinus via:
Foramen ovale
Foramen rotundum
Foramen Vesalii
Foramen spinosum
Buccinator is pierced by:
Submandibular duct
Sublingual duct
Parotid duct
Minor salivary duct
Anterior ethmoidal artery enters nasal cavity through:
Maxilla
Sphenoid
Ethmoid
Frontal
Orbit, Eye Muscles and Cranial Nerves — The muscle that elevates the upper eyelid develops from which embryological structure?
Surface ectoderm
Neural crest cells
Preotic somites
Optic vesicle
Orbit, Eye Muscles and Cranial Nerves — Superior oblique muscle of the eye is supplied by:
Oculomotor nerve
Trochlear nerve
Abducent nerve
Ophthalmic division of trigeminal nerve
Orbit, Eye Muscles and Cranial Nerves — All extraocular muscles except superior oblique and lateral rectus are supplied by:
CN II
CN III
CN IV
CN VI
Orbit, Eye Muscles and Cranial Nerves — The common tendinous ring (annulus of Zinn) gives origin to all except:
Superior rectus
Inferior rectus
Lateral rectus
Inferior oblique
Orbit, Eye Muscles and Cranial Nerves — The parasympathetic fibers to the pupil travel via:
Optic nerve
Oculomotor nerve
Trigeminal nerve
Abducent nerve
Ear (External, Middle, Inner) — External auditory canal develops from:
First pharyngeal pouch
First pharyngeal cleft
Second pharyngeal arch
Otic placode
Ear (External, Middle, Inner) — The malleus and incus are derived from:
First pharyngeal arch
Second pharyngeal arch
Third pharyngeal arch
Neural crest cells
Ear (External, Middle, Inner) — Stapes develops mainly from:
First arch
Second arch
Third arch
Otic vesicle
Ear (External, Middle, Inner) — Inner ear structures develop from:
Endoderm
Mesoderm
Otic placode
Neural crest
Ear (External, Middle, Inner) — The scala media of cochlea contains:
Perilymph
Endolymph
Cerebrospinal fluid
Blood plasma
Nose, Tongue and Olfactory Pathway — Olfactory epithelium is derived from:
Endoderm
Mesoderm
Neural crest
Surface ectoderm
Nose, Tongue and Olfactory Pathway — The cribriform plate allows passage of:
Optic nerve fibers
Facial nerve
Olfactory nerve fibers
Trigeminal nerve
Nose, Tongue and Olfactory Pathway — Anterior two-thirds of tongue develops from:
Second pharyngeal arch
Third pharyngeal arch
First pharyngeal arch
Fourth pharyngeal arch
Nose, Tongue and Olfactory Pathway — Taste sensation from anterior two-thirds of tongue is carried by:
Glossopharyngeal nerve
Hypoglossal nerve
Chorda tympani
Lingual nerve only
Nose, Tongue and Olfactory Pathway — Posterior one-third of tongue is supplied for taste by:
Facial nerve
Vagus nerve
Glossopharyngeal nerve
Hypoglossal nerve
Pharynx, Larynx, Thyroid and Parathyroid — Laryngeal cartilages develop from:
First pharyngeal arch
Second pharyngeal arch
Fourth and sixth pharyngeal arches
Third pharyngeal arch
Pharynx, Larynx, Thyroid and Parathyroid — Recurrent laryngeal nerve is a branch of:
Glossopharyngeal nerve
Facial nerve
Vagus nerve
Hypoglossal nerve
Pharynx, Larynx, Thyroid and Parathyroid — Thyroid gland develops from:
Foramen cecum
Second pharyngeal pouch
Third pharyngeal pouch
Fourth pharyngeal arch
Pharynx, Larynx, Thyroid and Parathyroid — Inferior parathyroid glands develop from:
Second pharyngeal pouch
Third pharyngeal pouch
Fourth pharyngeal pouch
Thyroglossal duct
Pharynx, Larynx, Thyroid and Parathyroid — Histologically, thyroid follicles are lined by:
Stratified squamous epithelium
Simple cuboidal epithelium
Simple columnar epithelium
Pseudostratified epithelium
Orbit and Eye Muscles — Which wall of the bony orbit is most commonly fractured in a ‘blowout’ injury due to its thin nature (lamina papyracea)?
Roof (orbital plate of frontal bone)
Lateral wall (zygomatic and sphenoid bones)
Medial wall (orbital plate of ethmoid bone)
Floor (orbital plate of maxilla)
Orbit and Eye Muscles — A patient presents with a complaint of difficulty looking down and out, and the eye rests in a position of slight elevation. This presentation is characteristic of a lesion in which cranial nerve?
Oculomotor nerve (CN III)
Trochlear nerve (CN IV)
What is the primary action of the Superior Oblique muscle when the eye is in the anatomical neutral position?
Elevation
Abduction
Intorsion (internal rotation)
Adduction
Which cranial nerve branch passes through the superior orbital fissure but is located outside the common tendinous ring?
Abducens nerve (CN VI)
Oculomotor nerve (CN III) - Superior division
Trochlear nerve (CN IV)
Optic nerve (CN II)
Complete ptosis (drooping eyelid) and a fixed, dilated pupil (mydriasis) are classic signs of injury to which component of the nervous system?
Oculomotor nerve (CN III)
Facial nerve (CN VII)
Sympathetic trunk in the neck
Trigeminal nerve (CN V)
The parasympathetic preganglionic fibers that synapse in the ciliary ganglion originate from which nucleus?
Superior Salivatory Nucleus
Edinger-Westphal Nucleus
Inferior Salivatory Nucleus
Nucleus Ambiguus
The general sensory innervation to the skin of the forehead, upper eyelid, and side of the nose is primarily supplied by branches of which division of the Trigeminal nerve (CN V)?
Mandibular division (CN V3)
Maxillary division (CN V2)
Ophthalmic division (CN V1)
Facial nerve (CN VII)
Which boundary of the orbit is formed entirely by the maxilla and zygomatic bone?
Superior margin
Medial margin
Inferior margin
Lateral margin
Which specific branch of the Ophthalmic nerve (CN V1) carries the postganglionic sympathetic fibers that reach the dilator pupillae muscle?
Lacrimal nerve
Long ciliary nerves (from the Nasociliary nerve)
Short ciliary nerves
Frontal nerve
Which cranial nerve provides the motor innervation to the Superior Rectus muscle?
Abducens nerve (CN VI)
Trochlear nerve (CN IV)
Oculomotor nerve (CN III)
Ophthalmic nerve (CN V1)
The lateral wall of the orbit separates the orbital cavity from which other anatomical space?
Ethmoid sinuses
Anterior cranial fossa
Temporal fossa
Maxillary sinus
Damage to which cranial nerve would specifically result in hyperacusis (increased sensitivity to loud sounds) due to paralysis of the stapedius muscle?
Trigeminal nerve (CN V)
Vestibulocochlear nerve (CN VIII)
Facial nerve (CN VII)
Glossopharyngeal nerve (CN IX)
What sensory components are carried by the chorda tympani nerve?
General sensation from the external acoustic meatus
Taste sensation from the anterior two-thirds of the tongue
Taste sensation from the posterior one-third of the tongue
General sensation from the tympanic membrane
A complete unilateral lesion of the Optic nerve (CN II) would result in which visual field defect?
Bitemporal hemianopsia
Contralateral homonymous hemianopsia
Total blindness in the ipsilateral eye
Upper quadrantanopsia
Which cranial nerve provides general somatic efferent (motor) fibers to the sternocleidomastoid and trapezius muscles?
Trigeminal nerve (CN V)
Facial nerve (CN VII)
Accessory nerve (CN XI)
Hypoglossal nerve (CN XII)
The tensor tympani muscle is innervated by a branch of which cranial nerve?
Facial nerve (CN VII)
Trigeminal nerve (CN V3)
Glossopharyngeal nerve (CN IX)
Vagus nerve (CN X)
Which of the following nerves carries preganglionic parasympathetic fibers that exit the skull through the jugular foramen and synapse in the otic ganglion?
Facial nerve (CN VII)
Glossopharyngeal nerve (CN IX)
Vagus nerve (CN X)
Trigeminal nerve (CN V)
