Anatomy Exam 4 – 2019

Included Content

  • Neck Triangles
  • Introduction to Cranial Nerves
  • Deep NeckExternal Cranium
  • Thyroid and Parathyroid Glands, and Root of Neck
  • Face, Scalp, and Parotid Regions
  • Temporal and Infratemporal Regions
  • Internal Cranium
  • Cranial Meninges, Brain Anatomy, and Blood Supply
  • Orbit
  • Pharynx
  • Nose
  • Oral Region
  • Larynx
  • Lymphoid Organ Histology
  • Ear
  • Pharyngeal Apparatus, Face, and Neck

1. George is a farmer who lives 90 minutes from your hospital. He is undergoing chemotherapy and he tells you that driving up for his weekly treatments is becoming overwhelming. You decide that he would be a good candidate for a port to deliver his medicine at home. You explain to him that a port would be inserted under the skin on his chest and an IV would be placed in his subclavian artery and he would be able to add the medication into the port. Which of the following spaces would you insert this permanent IV?

  1. Lesser supraclavicular fossa

  2. Suprasternal space

  3. Greater supraclavicular fossa

  4. Between the middle and anterior scalene muscles

  5. Between the middle and posterior scalene muscle

2. Which of the following would be located in the carotid sheath?

  1. Internal jugular

  2. External jugular

  3. Thyroid gland

  4. Parathyroid gland

  5. Accessory nerve

3. Felicia has an abscessed second molar. If this infection were to spread to which of the following spaces, it could potentially end up in her heart.

  1. Between anterior and posterior divisions of the investing fascia (suprasternal space)

  2. Between the investing layer and infrahyoid fascia

  3. Between alar fascia and prevertebral fascia

  4. Between buccopharyngeal fascia and alar fascia

  5. Between the carotid sheath and pretracheal fascia


4. Once ARCOM actually makes FOPC relevant, you’ll learn to place central lines. One such place you can place a central line is in the internal jugular vein. In which of the following spaces would you use to access the internal jugular vein?

  1. Suprasternal space

  2. Lesser supraclavicular space

  3. Greater supraclavicular space

  4. Lesser subclavicular space

  5. Greater subclavicular space

5. A patient is stabbed in a bar fight and the knife pierces the sternocleidomastoid and through to the anterior surface of the anterior scalene. Which nerve was likely severed?

  1. Vagus

  2. Greater Auricular

  3. Lesser Occipital

  4. Phrenic

  5. Posterior Auricular

6. In which of the following fascial layers are you likely to find the longus capitis muscle?

  1. Superficial Layer of the Deep Cervical Fascia

  2. Muscular Pretracheal fascia 

  3. Visceral Pretracheal fascia 

  4. Prevertebral fascia 

  5. Carotid Sheath

7. Which of the following smaller triangles is a part of the posterior neck triangle?

  1. Mental 

  2. Submandibular 

  3. Subclavian 

  4. Muscular 

  5. Carotid

8. Which of the following muscles does NOT receive its innervation from the cervical plexus ?

  1. Diaphragm 

  2. Sternothyroid 

  3. Hyoglossal

  4. Omohyoid 

  5. Sternohyoid

9. The carotid sinus is a bulging of the internal carotid artery just after the carotid bifurcation. The receptors in this area are best adapted to sense changes in which of the following?

  1. Oxygen levels

  2. Blood Pressure

  3. Carbon Dioxide levels

  4. Sodium Levels

  5. Calcium Levels

10. Which of the following is a branch off the internal carotid?

  1. Maxillary

  2. Lingual

  3. Occipital 

  4. Ophthalmic 

  5. Posterior Auricular

11. While running with scissors, Lucy managed to trip and stab the blade into her mastoid process. She now has difficulty opening and closing her mouth. It was discovered that she had damaged the nerve leading to her posterior digastric muscle. Which nerve is damaged?

  1. Inferior alveolar

  2. Superior alveolar

  3. Hypoglossal

  4. Facial nerve

  5. Nerve to mylohyoid 

12. While running with scissors, Lucy managed to trip and stab the blade into the soft part beneath her chin. She now has difficulty opening and closing her mouth. It was discovered that she had damaged the nerve leading to her anterior digastric muscle. Which nerve is damaged?

  1. Inferior alveolar

  2. Superior alveolar

  3. Hypoglossal

  4. Facial nerve

  5. Nerve to mylohyoid 

13. In order to perform a Tommy John surgery to repair a ruptured ulnar collateral ligament, you must deadinate Spinal roots C5-T1. Where should you insert the needle for the anesthesia?

  1. Between the anterior and middle scalene

  2. Between the middle and posterior scalene

  3. On the anterior border of the SCM

  4. On the posterior border of the SCM

  5. In the supraclavicular fossa

14. A patient comes to your office with difficulty speaking caused by problems elevating the hyoid bone secondary to paralysis of the posterior belly of the digastric muscle. Which nerve is most likely damaged?

  1. Accessory

  2. Ansa cervicalis

  3. Facial

  4. Glossopharyngeal

  5. Trigeminal


15. A patient complains of numbness over the skin of the anterior cervical triangle. Which nerve is most likely damaged?

  1. Greater auricular

  2. Lesser occipital

  3. Phrenic

  4. Supraclavicular

  5. Transverse cervical

16. Trudy has a lazy right eye caused by a trochlear nerve palsy. Which of the following symptoms is associated with this disorder?

  1. Double vision when looking up

  2. Drooping of upper eyelid

  3. Double vision when looking down

  4. Medial deviation of the eye at rest

  5. Lateral deviation of the eye at rest.

17. After a freak fly-fishing accident in which Bruce hooked himself in the superior orbital fissure, he managed to damage only one of the three nerves that exits the skull at that location: the trochlear. Which of the following muscles was affected?

  1. Superior rectus

  2. Superior oblique

  3. Medial rectus

  4. Inferior rectus

  5. Inferior oblique

18. After a freak fly-fishing accident in which Bruce hooked himself in the superior orbital fissure, he managed to damage only one of the three nerves that exits the skull at that location: the trochlear. Which of the following symptoms would you expect Bruce to present with?

  1. Inability to look up

  2. Inability to look down

  3. Inability to look laterally

  4. Double vision 

  5. Droopy eyelid

19. A patient presents to the ED in a frantic state and you notice that his right eye is constantly looking to his right and down. Which of the following nerves is likely damaged in this patient?

  1. Optic

  2. Oculomotor 

  3. Trochlear 

  4. Trigeminal 

  5. Abducens

20. Which branch of the trigeminal is responsible for sensory input from the superficial/external portion of the tympanic membrane?

  1. Temporal

  2. Ophthalmic 

  3. Zygomatic 

  4. Maxillary 

  5. Mandibular

21. A patient is found to have problems feeling his chin due to an issue from where the root nerve exits the cranial fossa. Which foramen/opening has been compromised?

  1. Foramen Spinosum 

  2. Superior Orbital Fissure

  3. Inferior Orbital Fissure 

  4. Foramen Rotundum 

  5. Foramen Ovale

22. A woman complains of numbness over the tip of her nose. Which nerve is most likely damaged?

  1. Auriculotemporal

  2. Facial

  3. Mandibular division of trigeminal

  4. Maxillary division of trigeminal

  5. Ophthalmic division of trigeminal

23. It has been said that Chuck Norris’s tears cure cancer, but he does not cry. The inability to cry would be due to which of the following?

  1. Paralysis of parasympathetic fibers of facial nerve proper

  2. Paralysis of parasympathetic fibers of intermediate nerve

  3. Paralysis of somatic sensory fibers of facial nerve proper

  4. Paralysis of somatic sensory fibers of intermediate nerve

  5. Paralysis of the submandibular ganglion


24. Which of the following muscles would become paralized due to a lesion in the Facial Nerve (CN VII)?

  1. Masseter 

  2. Buccinator 

  3. Stylopharengeus 

  4. Palatoglossus 

  5. Tensor Tympani

25. A lesion in which of the following nerves would cause a deficiency in saliva production when seeing all that beautiful Thanksgiving food once you go home for the break?

  1. Greater Petrosal 

  2. Deep Petrosal 

  3. Chorda Tympani 

  4. Tensor Tympani 

  5. Hypoglossal

26. A patient walks normally into the ER waiting room and starts yelling because he can’t hear out of his right ear. Which most accurately describes which nerve is damaged in this patient?

  1. Vestibulocochlear 

  2. Glossopharyngeal 

  3. Vestibular 

  4. Auriculotemporal 

  5. Cochlear

27. A patient has come into your clinic complaining of decreased taste sensations. On physical exam you notice his heart rate and bowel sounds are normal, he is able to protrude his tongue with full control and no deviation or atrophy noted, but when his gag reflex is elicited, his uvula deviates to the right side. Which of the following nerves is likely to have a lesion?

  1. R Hypoglossal 

  2. R Vagus 

  3. R Glossopharyngeal 

  4. L Glossopharyngeal 

  5. L hypoglossal

28. Knowing Throckmorton is going to throw a trick question on this exam, you start throwing some at your friends to see if they can catch it. When asking them where the spinal accessory nerve (CN XI) enters the cranial cavity, what should they say?

  1. Internal auditory meatus 

  2. Stylomastoid foramen 

  3. Jugular foramen 

  4. Hypoglossal Canal 

  5. Foramen Magnum

29. When performing your physical for your final FOPC practical you notice the patient has a real condition when she attempts to stick out her tongue straight and it deviates to the left side. What nerve is likely damaged in your SP?

  1. R glossopharyngeal 

  2. L glossopharyngeal 

  3. R hypoglossal 

  4. L hypoglossal 

  5. SP’s never have anything actually wrong with them

30. Which of the following ganglions is the location of the synapse of the parasympathetic fibers that will eventually innervate the parotid gland?

  1. Ciliary 

  2. Otic

  3. Pterygopalatine 

  4. Submandibular 

  5. Superior Cervical

31. A man fractures the floor of his middle cranial cavity, severing the greater petrosal nerve. Which condition will most likely occur?

  1. Decreased parotid gland secretion

  2. Dryness in the nose and conjunctiva

  3. Increased lacrimal gland secretion

  4. Loss of sensation in the epiglottis

  5. Loss of sensation in the pharynx


32. The chordae tympani nerve exits the skull through which opening to enter the IT fossa?

  1. Foramen lacerum

  2. Foramen spinosum

  3. Petrotympanic fissure

  4. Stylomastoid foramen

33. Lori had a thyroidectomy performed after her doctor found an abnormal mass of cells that he could not identify as cancerous or noncancerous. Now, months later she is in your clinic feeling weak, tired and suffering from her third kidney stone since the operation. You run lab tests and conclude that her calcium levels are elevated. What is causing her symptoms?

  1. When her doctor removed her thyroid, he translocated her parathyroid glands to her arm

  2. When her doctor removed her thyroid, he did not properly translocate all of her parathyroid glands

  3. The thyroid is responsible for regulating acetylcholine and calcium release, so without it she is going to feel more tired

  4. These are common side effects of synthroid which is prescribed to patients after a thyroidectomy

  5. Lori is going through menopause

34. Which of the following is not a potential complication of a thyroidectomy?

  1. Tetany

  2. Aphasia 

  3. Dysphasia

  4. Cutting of recurrent laryngeal nerves

  5. Removal of parathyroid glands

35. While out drinking one night, James said the wrong thing to a person in the parking lot and got stabbed in the middle of his anterior scalene. Which of the following muscles is the most likely to show signs of ischemia from this injury?

  1. Rhomboid major

  2. Semispinalis

  3. Trapezius

  4. Supraspinatus

  5. Obliquus capitis superior

36. When the vertebral artery becomes occluded, it can cause patients to become dizzy and make their vision blurry. Which of the following arteries does this artery arise from?

  1. Common carotid

  2. Brachiocephalic 

  3. Division 1 of subclavian

  4. Division 2 of subclavian

  5. Division 3 of subclavian

37. Kelsey suffers from Horner syndrome which affects the cervical sympathetic trunk. Which of the following symptoms would you expect her to display

  1. Pupillary dilation

  2. Drooping of eyelid

  3. Vasoconstriction of the face

  4. Excess sweating on the face and neck

  5. Protrusion of eyeball out of the socket

38. Weston has been experiencing a severe headache that seems to be localized behind his left ear. He says it started after an inner ear infection he got while swimming at the Lake of the Ozarks last month. Physical examination reveals swelling and redness behind the left ear as well. A blood test confirms that he has mastoiditis, or inflammation and infection in his left mastoid process. Where would this infection drain to be returned to the central circulatory system?

  1. Junction between the internal jugular vein and subclavian vein

  2. Junction between the anterior jugular vein and the communicating vein

  3. Bifurcation of the internal and external jugular vein

  4. Bifurcation of the internal and external carotid vein

  5. Bifurcation of the right and left subclavian vein

39. A recent study done in 2014 in Taiwan shows that patients who suffer from panic disorders have a higher incidence of completely occluding their internal jugular veins during a valsalva maneuver than patients who do not suffer from panic attacks. This would partially account for the symptoms seen by patients during a panic attack such as feeling weak, faint, or dizzy. Which of the following vessels still allows drainage of the thyroid when patients are experiencing a panic attack?

  1. Superior thyroid vein

  2. Middle thyroid vein

  3. Inferior thyroid vein

  4. Superior thyroid artery

  5. Thyroid ima artery

40. A patient with severe difficulty breathing has a low tracheotomy performed below the isthmus of the thyroid. Which structure could most likely be damaged during this procedure?

  1. Costocervical trunk

  2.  Inferior thyroid artery

  3.  Inferior thyroid vein

  4. Right brachiocephalic vein

  5.  Superior thyroid artery

41. The foramen lacerum has been described as a portal of entry into the cranium for tumors. In which bone(s) is this foramen found?

  1. Occipital

  2. Temporal

  3. Palatine

  4. Sphenoid

  5. Ethmoid 

42. Which of the following fontenelles is the last to close?

  1. Posterior

  2. Anterior

  3. Mastoid

  4. Sphenoid 

  5. Bregma 

43. One of the tell-tale signs of dehydration in an infant is a sunken soft spot. This “soft spot” is caused by which fontenelle?

  1. Posterior

  2. Anterior

  3. Mastoid

  4. Sphenoid 

  5. Bregma 

44. An angiogram of a man shows occlusion of the thyrocervical trunk of the subclavian artery. This obstruction will decrease blood flow to which artery?

  1.  Ascending pharyngeal

  2.  Facial

  3. Lingual

  4. Inferior thyroid

  5. Superior thyroid

45. When you receive your BECOM grade, which of the following helps with medial movement of your tears?

  1. Orbicularis oris

  2. Levator labii superioris

  3. Depressor anguli oris

  4. Orbicularis oculi

  5. Occipitofrontalis

46. While meeting a 120 pound bull-mastiff-pitbull mix, he decided you were too close to his owner so he pins you down and takes a chomp out of the back of your head. It starts bleeding profusely resulting in an ER trip and 11 staples over the one inch laceration since the doctor couldn’t see where the bleeding started or ended. Which of the following is the most likely cause of the bleed?

  1. Internal carotid

  2. External carotid

  3. Superficial temporal

  4. Occipital

  5. Posterior auricular

47. Walking into the kitchen on Thanksgiving causes your parotid gland to start salivating. Which of the following nerves is responsible for this function?

  1. Parotid plexus

  2. Facial nerve

  3. Glossopharyngeal nerve

  4. External carotid plexus

  5. Trigeminal nerve

48. After ingesting a toxic substance, a young girl is unable to close her lips when her mouth is closed. Which muscle is most likely paralyzed?

  1.  Depressor labii inferioris

  2. Lateral pterygoid

  3. Levator labii superioris

  4. Orbicularis oris

  5.  Zygomaticus minor

49. Delbert is driving his wife crazy by grinding his teeth at night. Which muscle is primarily in charge of his wife’s agony?

  1. Temporalis

  2. Masseter

  3. Lateral pterygoid

  4. Medial pterygoid

  5. Bucinator 

50. Which of the following is a distinct feature of the TMJ that makes it different from other hinge joints?

  1. It allows for movement in 3 planes

  2. It allows for movement in 2 planes

  3. It is made of fibrocartilage

  4. It is made of hyaline cartilage

  5. It is made of elastic cartilage

51. Which of the following helps to prevent posterior dislocation of the temporomandibular joint

  1. Postglenoid tubercle

  2. Lateral ligament

  3. Stylomandibular ligament

  4. Sphenomandibular ligament

  5. All of the above

52. McCune-Albright Syndrome (MAS) is a rare disorder that affects the bone, skin and endocrine systems. Children with this disease present with precocious puberty, polyostotic fibrous dysplasia and cafe-au-lait pigmented skin lesions.  If a fibrous cyst is found on the foramen ovale of an affected patient, which of the following symptoms would you expect to see?

  1. Inability to move eye laterally 

  2. Inability to move eye medially

  3. Inability to feel lower lip

  4. Inability to feel upper lip

  5. Temperature sensitivity to teeth

53. Fracture to which of the following has the highest incidence of hematoma?

  1. Foramen rotundum

  2. Foramen ovale

  3. Foramen spinosum

  4. Foramen lacerum

  5. Foramen cecum

54. Anthony was in a car accident. X-rays showed a fracture to the cellar turcica. Which of the following would be consistent with this finding?

  1. Battles sign

  2. Racoon eyes

  3. Loss of smell

  4. Loss of sight

  5. Loss of taste

55. Jeffrey fell off of a two story roof that he had been working on. In the ER he is found to have bruising behind his ear, a loss of smell, and CSF coming out of his nose. Which of the following would you most likely find a fracture?

  1. Cella tursia

  2. Perpendicular plate of vomer

  3. Bregma 

  4. Mamillary process

  5. Sigmoid sinus

56. Tumors of the pituitary gland tend to cause disturbances in endocrine function and can result in reduced peripheral vision. Which of the following structures does the tumor intrude upon?

  1. Cerebellar falx

  2. Sellar diaphragm

  3. Cerebellar tentorium

  4. Cerebral falx

  5. Periosteum 

57. Which of the following would you expect to see in a patient that has a subdural hematoma?

  1. Inability to internally rotate the eye

  2. Inability to look up

  3. Inability to smell

  4. Loss of balance

  5. Inability to hear

58. A patient with a laceration involving the facial vein could develop meningitis from bacteria entering the dural sinus system by which vein/plexus/sinus?

  1. Greater cerebral vein

  2. Superior sagittal sinus

  3. Internal jugular or external jugular

  4.  Cavernous sinus


59. Granular foveolae can be observed in the major sinuses of the brain. Which of the following is a cause for these?

  1. Leaking of CSF causing a buildup of pressure

  2. Blunt force trauma to the top of the head

  3. Pacchionian bodies eroding the bone

  4. Abnormal fusing of the sutures

  5. Pooling of blood in the subarachnoid space

60. Which of the following is the most likely to have a metastasis from cancer in the vertebral canal?

  1. Sigmoid

  2. Transverse

  3. Straight

  4. Occipital

  5. Inferior Sagittal

61. Angela got too close to her playful kitten and he clawed the side of her nose, drawing blood. That night when she was washing her face, she reused a washcloth, not knowing that her brother had used it to wipe pus out of his staph infection. Three days later, she is in the hospital with flu-like symptoms. A spinal tap shows that she has staph bacterial meningitis. Which of the following sinuses was most likely the cause of this spread of infection?

  1. Occipital

  2. Cavernous

  3. Superior sagittal

  4. Inferior sagittal

  5. Sigmoid

62. Which of the following Cranial nerves comes from the Pons?

  1. Facial

  2. Trochlear 

  3. Hypoglossus 

  4. Trigeminal

  5. Vestibulocochlear 

63. Amy brings in her 3 week old infant who has been running a fever, refusing to feed, and breathing rapidly. You notice her baby has a bulging fontanelle and want to run a test to rule out meningitis. Which of the following is the preferred place to perform a spinal tap on a newborn infant?

  1. Between L1 and L2

  2. Between L4 and L5

  3. In the cerebellomedullary cistern

  4. In the pontocerebellar cistern

  5. In the chiasmatic cistern 

64. A man involved in a car accident hits his temple on the steering wheel. Though he initially is able to respond to questions, he lapses into unconsciousness on the way to the hospital. CT scan shows a rupture of the middle meningeal artery. Which space is blood most likely leaking into within his cranium?

  1. Cranial dural sinuses

  2. Epidural

  3. Subarachnoid

  4. Subdural

  5.  Subpial


65. Which sinus is found on either side of the sphenoid bone?

  1. Cavernous

  2. Confluence of sinuses

  3. Sigmoid

  4. Straight

  5. Superior petrosal


66. A 75-year-old woman presents to your office complaining of the “worst headache of her life” and vision loss. Radiographic examination reveals a cerebral aneurysm. In which space would blood most likely be pooling?

  1. Cranial dural sinuses

  2. Epidural

  3. Subarachnoid

  4. Subdural

  5. Subpial


67. A 16-year-old male presents with cavernous sinus septic thrombosis caused by a boil in the nasal vestibule. Which dysfunction would most likely be observed?

  1. Diminished sensation on chin

  2. Lack of corneal reflex

  3. Loss of taste on anterior 2/3 of tongue

  4. Reduced olfaction

  5. Tongue deviates to one side


68. A man is unable to open his eye due to a rare neuromuscular disease. Which muscle is most likely paralyzed?

  1. Frontalis

  2.  Levator palpebrae superioris

  3. Orbicularis oculi

  4. Orbicularis oris

  5.  Superior rectus


69. A 61-year-old woman is found to have ocular lymphoma invading her optic canal. Which structure is most likely to be damaged?

  1. Oculomotor nerve

  2. Ophthalmic artery

  3. Ophthalmic nerve

  4. Ophthalmic vein

  5. Trochlear nerve


70. A woman is able to see far away objects clearly but is unable to focus on close objects. This dysfunction is most likely due to impairment of which structure?

  1. Ciliary body (muscle)

  2. Dilator pupillae

  3. Orbitalis muscle

  4. Tarsal muscle

  5. Sphincter pupillae

71. During an eye exam, your patient’s right eye is unable to glide up and in (nasally) when you perform the “H test” (clinical eye movement test). Which nerve is most likely damaged?

  1. Abducens

  2. Oculomotor

  3. Optic

  4. Trochlear

  5. V1


72. A 32-year-old female is admitted to the emergency department with a medial blowout fracture of the orbit. Orbital contents have most likely herniated into which space?

  1.  Anterior cranial fossa

  2. Ethmoid sinus

  3.  Maxillary sinus

  4.  Pterygopalatine fossa

  5.  Sphenoid sinus 

73. Many children suffer from chronic ear infections. Severe cases of recurring ear infections in which part of the ear could be alleviated by a myringotomy where an incision is made in the eardrum to remove fluid and a tympanostomy tube is placed allowing for better drainage.

  1. External ear

  2. Middle ear

  3. Internal ear

  4. Cochlea

  5. Eustachian tube

74. Which of the following, if damaged would not affect mastication or deglutition?

  1. Vagus

  2. Glossopharyngeal

  3. Trigeminal nerve

  4. Facial nerve

  5. Hypoglossal nerve

75. Which of the following is innervated by the glossopharyngeal nerve

  1. Superior pharyngeal constrictor

  2. Middle pharyngeal constrictor

  3. Inferior pharyngeal constrictor

  4. Stylopharyngeous 

  5. Salphingopharyngeous 

76. Kelvin comes into your clinic complaining of dysphagia and severe halitosis regardless of how many times he brushes his teeth. He says he is not in pain, but the symptoms are affecting his daily test. You decide to do a Barium swallow test and diagnose him with Zenker’s Diverticulum. In which of the following regions would you expect to see the diverticulum?

  1. Superior pharyngeal constrictor

  2. Middle pharyngeal constrictor

  3. Inferor pharyngeal constrictor

  4. Cricophayngeous

  5. Nasopharynx

 77. Which cranial nerve supplies the afferent nerve fibers for the pharyngeal gag reflex?

  1. Facial

  2. Glossopharyngeal

  3. Hypoglossal

  4. Trigeminal

  5. Vagus

78. Tim was playing rugby when the ruck knocked him on his face and his teammate tripped over him smashing his face into the ground. When he was x-rayed, there were no broken bones, but his nose now looks crooked. He most likely damaged which structure?

  1. Nasal bone

  2. Lateral cartilage

  3. Lacrimal bone

  4. Septal cartilage

  5. Alar cartilage 

79. Karter is a 5 year old who comes into your office picking his nose. In which structure did those tasty nuggets form?

  1. Pseudostratified ciliated epithelium

  2. Goblet cells

  3. Nasociliary duct

  4. Nasolacrimal duct

  5. Sphenoethmoidal recess

80. Where does the speno-ethmoidal recess drain?

  1. Sphenoid sinus

  2. Posterior ethmoidal cells

  3. Middle ethmoidal cells

  4. Middle nasal meatus

  5. Superior nasal meatus

81. Abscessed teeth can cause major issues if they end up in the maxillary sinus. Which of the following stuctures indicates the maxillary sinus

  1. A

  2. B

  3. C

82. A 22-year-old female visits the outpatient clinic with a sinus infection of 2 weeks duration. Physical examination reveals that the patient has focal inflammation with mucosal edema in the inferior nasal meatus. Drainage from which structure is most likely obstructed?

  1. Anterior ethmoidal air cells

  2. Maxillary sinus

  3. Nasolacrimal duct

  4. Sphenoid sinus


83. A 55-year-old male with a history of cocaine abuse is brought to the emergency department because of severe uncontrolled epistaxis. Flexible endoscopy reveals the source of bleeding to be in Kiesselbach’s area. Which arteries are involved in this condition?

  1. Branches of sphenopalatine, superior labial, and anterior ethmoidal

  2. Branches of infraorbital, lingual, and  deep temporal

  3. Descending palatine and ascending pharyngeal

  4. Lateral branches of posterior ethmoidal and middle meningeal

  5. Posterior superior alveolar and accessory meningeal


84. Hank was in a bar fight last night that fractured his jaw. Upon examination, you notice that his tongue looks like the above image when he sticks it out. Which nerve was damaged

  1. Hypoglossal

  2. Glossopharyngeal 

  3. Vagus

  4. Trigeminal

  5. Facial

85. A patient presents to your clinic with loss of sensation of the anterior 2/3 of her tongue. She can still taste food and has no other deficits. Where do you expect to most likely find a nerve lesion?

  1. Chorda tympani

  2. Geniculate Ganglion

  3. Glossopharyngeal nerve

  4. Greater petrosal nerve

  5. Lingual nerve


86. A woman with tetanus is unable to open her mouth or jaw. Which muscle is most likely paralyzed by the tetanus toxin?

  1. Buccinator

  2. Lateral pterygoid

  3. Masseter

  4. Medial pterygoid

  5. Temporalis


87. A dentist wishing to numb the lower teeth would need to inject anesthetic into which nerve?

  1.  Auricotemporal

  2.  Buccal

  3. Inferior Alveolar

  4. Lingual

  5.  Mental 


88. A patient complains of not being able to taste on the posterior 1/3 of his tongue following an operation. Which nerve is most likely injured?

  1. Chorda tympani

  2. Glossopharyngeal

  3. Greater palatine

  4. Hypoglossal

  5. Lingual

89. Beth is choking on a piece of steak. If it is lodged in her larynx, where is the most likely place that it is lodged?

  1. Epiglottis

  2. Laryngeal vestibule

  3. Laryngeal ventricle

  4. Vestibular fold

  5. Vocal fold

90. Paralysis of the posterior cricoarytenoid muscle would cause what?

  1. Inability to speak above a whisper

  2. Death 

  3. Inability to speak in a whisper

  4. Inability to swallow

  5. Inability to chew

91. Damage to the conus elasticus would result in which of the following clinical presentations?

  1. Inability to swallow

  2. Inability to raise the soft palate

  3. Inability to speak

  4. Inability to breath

  5. Inability to salivate

92. While on your surgical rotation, your preceptor tell you that you can be first assist if you can tell him what nerve, if damaged would cause stridor and anxiety. You confidently respond ______ and go to scrub in.

  1. Superior laryngeal

  2. Inferior laryngeal

  3. Recurrent laryngeal

  4. External laryngeal

  5. Internal laryngeal

93. A patient has difficulty abducting the vocal cords during quiet breathing. Which muscle is most likely damaged?

  1. Cricothyroid

  2. Oblique arytenoid

  3. Posterior cricoarytenoid

  4. Thyroarytenoid

  5. Vocalis


94. A woman has a hoarse voice and her uvula deviates to the left on phonation. Which nerve is most likely damaged?

  1. Left glossopharyngeal

  2. Left trigeminal

  3. Left vagus

  4. Right glossopharyngeal

  5. Right vagus

95. Ellie is a curious three year old patient of your attending. She asks you where earwax comes from and you tell her it comes from deep in her ear. When you get outside of the room, your attending asks you which specific part of the ear earwax is from. You respond:

  1. Inner ear

  2. Middle ear

  3. Pharyngotympanic tube

  4. Bony part of external ear

  5. Cartilaginous part of external ear


96. A patient complains of hyperacusis (perceiving sounds to be very loud). You determine that this is due to a dysfunction of their tensor tympani muscle. Which nerve is most likely damaged?

  1. Facial

  2. V1

  3. V2

  4. V3

  5. Vestibulocochlear