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70 Cards in this Set
- Front
- Back
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A 38-year-old man has had thyroid surgery to remove his papillary carcinoma. The external laryngeal nerve that accompanies the superior thyroid artery is damaged during the surgery. This injury could result in a severe impairment of function of which of the following?
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Tensing the vocal cords
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A 27-year-old woman with a goiter comes to the hospital for surgical treatment. The sur¬geon must ligate the superior laryngeal artery before surgically resecting the goiter, so care must be taken to avoid injury to which of the following nerves?
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Internal laryngeal nerve
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A 19-year-old woman complains of numbness of the nasopharynx after surgical removal of the adenoid. A lesion of which of the following nerves would be expected?
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Glossopharyngeal nerve
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During surgery on a 56-year-old man for a squamous cell carcinoma of the neck, a sur¬geon notices profuse bleeding from the deep cervical artery. Which of the following arteries must be ligated immediately to stop bleeding?
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Costocervical trunk
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A 17-year-old boy receives an injury to the phrenic nerve by a knife wound in the neck. The damaged nerve passes by which of the following structures in the neck?
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Superficial to the anterior scalene muscle
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A 45-year-old woman is suffering from numbness over the tip of her nose. Which of the following nerves is most likely to be damaged?
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Ophthalmic division of the trigeminal nerve
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A 26-year-old singer visits her physician— an ear, nose, and throat (ENT) surgeon—and complains of changes in her voice. A laryngo¬scopic examination demonstrates a lesion of the superior laryngeal nerve, causing weakness of which of the following muscles?
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Inferior pharyngeal constrictor
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A 44-year-old man with "crocodile tears syndrome" has spontaneous lacrimation during eating because of misdirection of regenerating autonomic nerve fibers. Which of the following nerves has been injured?
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Facial nerve proximal to the geniculate ganglion
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A young girl complains of dryness of the nose and the palate. This would indicate a lesion of which of the following ganglia?
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Pterygopalatine ganglion
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. A 33-year-old woman develops Bell's palsy. She must be cautious because this can result in corneal inflammation and subsequent ulceration. This symptom results from which of the following conditions?
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Absence of the corneal blink reflex
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A 39-year-old woman presents to your clinic with complaints of headache and dizziness. She has an infection of a cranial dural sinus. The sinus that lies in the margin of the tentorium cerebelli and runs from the posterior end of the cavernous sinus to the transverse sinus is infected. Which of the following sinuses is affected by inflammation?
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Superior petrosal sinus
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A 34-year-old man in a bar fight suffers a knife wound that severs the abducens nerve proximal to its entrance into the orbit. Which of the following conditions results from this injury?
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Internal strabismus (medial deviation)
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A 24-year-old man falls from his motorcycle and lands in a creek. Death may result from bilateral severance of which of the following nerves?
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Vagus nerve
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A 25-year-old man is involved in an auto¬mobile accident and slams his head into a con¬crete wall of a bridge. His computed tomography (CT) scan reveals that the middle meningeal artery has ruptured but the meninges remain intact. Blood leaking from this artery enters which of the following spaces?
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Epidural space
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A 27-year-old paratrooper lands on a pine tree. Consequently, preganglionic parasympa¬thetic nerves leaving the central nervous system are lacerated. Which of the following structures contain cell bodies of the damaged nerve fibers?
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Brainstern and sacral spinal cord
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Following radical resection of a primary tongue tumor. a 72-year-old patient has lost general sensation on the anterior two thirds of the tongue. This is probably due to injury to branches of which of the following nerves?
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Trigeminal nerve
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A 67-year-old woman comes to her physi¬cian complaining of visual loss. Her magnetic resonance imaging (MRI) scan shows an enlarged pituitary gland that lies in the sella turcica, immediately posterior and superior to which of the following structures?
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Sphenoid sinus
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After having a tonsillectomy, a 57-year-old man with a long history of chewing tobacco use is unable to detect taste on the posterior one third of his tongue. Which of the following nerves has most likely been injured?
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Glossopharyngeal nerve
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A 14-year-old boy hits his head on the asphalt road after falling off his skateboard. His radiograph reveals damage to the sella turcica This is probably due to fracture of the following bones?
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Sphenoid bone
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The nerve accompanying the superior thyroid artery may be damaged during an operation on the thyroid gland. Which of the following functional defects may result from this injury?
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Decreased tension of the vocal cord
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A 37-year-old patient has an infectious inflammation of the dural venous sinus closest to the pituitary gland and a secondary thrombus formation. Which of the following is the most likely site of infection?
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Cavernous sinus
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A 53-year-old woman is diagnosed as having a pituitary tumor. If the tumor is large enough, she could exhibit which of the following disorders?
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Bitemporal (heteronymous) hemianopia
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A young singer at the local music theater visits her physician and complains of vocal difficulties. On examination, she is unable to abduct the vocal cords during quiet breathing. Which of the following muscles is most likely paralyzed?
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Posterior cricoarytenoid muscle
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A 71-year-old woman often visits an emergency department with swallowing difficulties and subsequent choking while eating food. Which of the following pairs of muscles is most
instrumental in preventing food from entering the larynx and trachea during swallowing? |
Oblique arytenoid and aryepiglottic muscles
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A 31-year-old woman complains of headache and dizziness after hitting a kitchen cabinet door with her head. Her magnetic resonance imaging (MRI) scan and venogram show a large blood clot in the great cerebral vein of Galen. The obstructed vein of the brain is a direct tributary of which of the following venous structures?
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Dural venous sinuses
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A 41-year-old woman overdoses on some prescription medications that have a common side effect of autonomic nerve stimulation. Which of the following conditions or actions results from stimulation of the parasympathetic fibers to the eyeball?
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Contraction of the ciliary muscle
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A 53-year-old woman with a severe middle ear infection comes to a hospital. On examination, a physician finds that the infection has injured the tympanic nerve. The damaged nerve:
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Is a branch of the glossopharyngeal nerve
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A 13-year-old boy competing in a motocross competition falls from his bike and sustains massive head injuries. Which of the following cavities are separated from the middle cranial fossa by a thin layer of bone?
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Middle ear cavity and sphenoid sinus
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A 32-year-old house painter suffers from a head injury after falling off a ladder and has bleeding in his head. During intraoperative testing, the neurosurgeon notes loss of general sensation in the dura of the middle cranial fossa. Which of the following nerves has been affected?
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Trigeminal nerve
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During a carotid endarterectomy of a 57- year-old man who suffered a stroke, the carotid sinus is damaged. A third-year medical student in surgical rotation notices that the injured structure:
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Is stimulated by changes in blood pressure
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During a game, a 26-year-old baseball player is hit in the head by a baseball, which fractures the optic canal. Which of the following pairs of structures is most likely to be damaged?
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Ophthalmic artery and optic nerve
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A 43-year-old man has new onset of difficulty with speaking. Examination by the ear, nose, and throat (ENT) resident reveals problems in elevating the hyoid bone and floor of the mouth, secondary to paralysis of the posterior belly of the digastric muscle. Which of the following nerves is most likely involved?
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Facial nerve
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The drummer of a local band presents to your clinic with hearing loss. Otoscopic examination reveals loss of contraction of the tensor tympani and the stapedius, which prevents damage to the eardrum and middle ear ossicles. These muscles are most likely controlled by which of the following nerves?
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Trigeminal and facial nerves
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The pupil in the eye of a 43-year-old patient remains small even when room lighting is dim. Which of the following nerves would be injured?
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Superior cervical ganglion
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A pharyngeal (gag) reflex is the contraction of the pharyngeal constrictor muscles that is elicited by touching the back of a patient's pharynx (e.g., with a tongue depressor). Afferent nerve fibers that innervated the pharyngeal mucosa are branches of which of the following nerves?
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Glossopharyngeal nerve
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A patient can move his eyeballs normally and see distant objects clearly but cannot focus on near objects. This condition may indicate damage to which of the following structures?
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Short ciliary nerves and ciliary ganglion
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A benign tumor in the orbit of a 49-yearold man compresses a structure that runs through both the superior orbital fissure and the common tendinous ring. Which of the following structures is most likely damaged?
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Abducens nerve
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A 37-year-old man feels a little discomfort when moving his tongue, pharynx, and larynx. Physical examination indicates that the muscles attached to the styloid process are paralyzed. Which of the following groups of cranial nerves are damaged?
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Facial, glossopharyngeal, and hypoglossal nerves
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A 32-year-old woman has hoarseness in her voice, and her uvula is deviated to the left on phonation. Which of the following nerves is damaged?
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Right vagus nerve
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A high school basketball player experiences a sudden difficulty in breathing and is brought to an emergency room. When a low tracheotomy is performed below the isthmus of the thyroid, which of the following vessels may be encountered?
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Inferior thyroid vein
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A 59-year-old man complains of numbness in the anterior cervical triangle. Therefore, damage has occurred to which of the following nerves?
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Transverse cervical nerve
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A 53-year-old man has difficulty with breathing through his nose. On examination, his physician finds that he has swelling of the
mucous membranes of the superior nasal meatus. Which opening of the paranasal sinuses is most likely plugged? |
Posterior ethmoidal sinus
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Following a penetrated injury in the sub- mandibular triangle, the tongue of a 45-yearold patient deviates to the left on protrusion. Which of the following nerves is injured?
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Left hypoglossal nerve
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A 47-year-old man cannot move his eye laterally. Which of the following conditions would cause this type of inability to move the eye?
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Infection in the cavernous sinus
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A young boy with a tooth abscess from a longstanding infection suffers damage of the lingual nerve as it enters the oral cavity. Which of the following structures contain cell bodies of injured nerve fibers?
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Geniculate and trigeminal ganglia
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A 61-year-old woman is found to have ocular lymphoma invading her optic canal. Which of the following structures would most likely be damaged?
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Ophthalmic artery
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A 76-year-old man with swallowing difficulties undergoes imaging for a possible mass. The computed tomography (CT) scan image at the level of the cricothyroid ligament in his neck should show which of the following structures?
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Inferior laryngeal nerves
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A knife wound has severed the oculomotor nerve in a 45-year-old man. Which of the following conditions will occur because of this injury?
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Paralysis of the ciliary muscle
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The muscles that are of branchiomeric origin are paralyzed in a 26-year-old patient. A lesion of which of the following nerves would cause muscle dysfunction?
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Trigeminal nerve
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During surgery for a malignant parotid tumor in a 69-year-old woman, the main trunk of the facial nerve is lacerated. Which of the following muscles is paralyzed?
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Buccinator muscle
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During a gang fight, a 17-year-old boy is punched, and his nasal septum is broken. Which of the following structures would be damaged?
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Vomer and perpendicular plate of ethmoid
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A 58-year-old woman comes to a hospital and complains of progressive loss of voice, numbness, loss of taste on the back part of her tongue, and difficulty in shrugging her shoulders. Her magnetic resonance imaging (MRI) scan reveals a dural meningioma that compresses the nerves leaving the skull. These nerves leave the skull through which of the following openings?
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Jugular foramen
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A 21-year-old woman presents to her physician with a swelling on her neck. On examination, she is diagnosed with an infection within the carotid sheath. Which of the following structures would be damaged?
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Internal jugular vein and vagus nerve
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An angiogram of a 45-year-old man shows an occlusion of the costocervical trunk. This obstruction could produce a marked decrease in the blood flow in which of the following arteries?
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Deep cervical artery
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A 20-year-old guard at the gate of the Royal King's palace blinks his eyes when a strong wind hits the cornea of his eye. The afferent fibers of the corneal reflex arc are carried by which of the following nerves?
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Nasociliary nerve
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A 57-year-old man comes to a local hospital with fever, headache, nausea, and vomiting. Laboratory tests reveal an infection, and radio- logic examination localizes the infection to the cavernous sinus. Which of the following nerves would be unaffected by this condition?
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Mandibular nerves
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A 7-year-old girl has difficulty breathing through her nose and is brought to her pediatrician. On examination, she is diagnosed with adenoids. Which of the following tonsils is enlarged?
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Pharyngeal tonsil
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A 65-year-old man with multiple vision problems comes to a local eye clinic. The pupillary light reflex can be eliminated by cutting which of the following nerves?
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Oculomotor, short ciliary, and optic nerves
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A 59-year-old woman with pain at the side of her skull comes to the emergency department. An emergent head computed tomography (CT) scan shows a large lesion in the internal auditory meatus. This condition may progress and damage which of the following pairs of structures?
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Facial and vestibulocochlear nerves
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A 22-year-old patient has dryness of the corneal surface of his eye because of a lack of tears. Which of the following nerves may be damaged?
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Greater petrosal nerve
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After ingesting a toxic substance found in her friend's home, a 12-year-old girl is unable to close her lips. Which of the following muscles may be paralyzed?
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Orbicularis oris
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A 12-year-old boy has difficulty in breathing because he is choking on food. A school nurse performs the Valsalva maneuver to expel air from his lungs and thus dislodge the food. When that fails, she performs a needle cricothyrotomy, which would open into which of the following regions?
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Infraglottic cavity
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A 37-year-old man receives a direct blow to his head and is brought to an emergency department. His x-ray film shows a fracture of the floor of the middle cranial cavity, causing severance of the greater petrosal nerve. Which of the following conditions could be produced by this injury?
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Dryness in the nose and palate
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A 59-year-old stroke patient is unable to swallow because of a nerve injury. Which of the following nerves is unaffected?
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Spinal accessory nerve
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A 71-year-old man suffers from a known benign tumor in the pterygoid canal. Which of the following nerve fibers could be injured by this condition?
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General visceral afferent (GVA) fibers
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A 64-year-old woman is unable to open her mouth or jaw because of tetanus resulting from a penetrating wound from a rusty nail. Which of the following muscles would most likely be paralyzed?
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Lateral pterygoid muscle
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A 60-year-old man is unable to open his eye because of a rare neuromuscular disease. Which of the following muscles would most likely be paralyzed?
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Levator palpebrae superioris
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A 31-year-old hockey player is hit in the head by a puck. His radiogram shows a fracture of the foramen rotundum. Which of the following nerves would be damaged by this event?
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Maxillary nerve
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A 46-year-old man visits the speech therapist complaining of dryness of the mouth. The therapist performs a swallowing study and, on examination, finds that the man has a lack of salivary secretion from the submandibular gland. This indicates a lesion of which of the following nervous structures?
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Chorda tympani in the middle ear cavity
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A 51-year-old woman traveling through British Columbia can see the beautiful blue sky with white clouds but is unable to focus on her face in the mirror. Her lack of accommodation results from paralysis of which of the following muscles?
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Ciliary muscles
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