Head And Neck

Front 1

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?
(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

Back 1

C

Front 2

A 27-year-old woman with a goiter comes
to the hospital for surgical treatment. The surgeon
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?
(A) External laryngeal nerve
(B) Internal laryngeal nerve
(C) Superior laryngeal nerve
(D) Hypoglossal nerve
(E) Vagus nerve

Back 2

B

Front 3

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?
(A) Maxillary nerve
(B) Superior cervical ganglion
(C) External laryngeal nerve
(D) Glossopharyngeal nerve
(E) Vagus nerve

Back 3

D

Front 4

During surgery on a 56-year-old man for a
squamous cell carcinoma of the neck, a surgeon
notices profuse bleeding from the deep
cervical artery. Which of the following arteries
must be ligated immediately to stop bleeding?
(A) Inferior thyroid artery
(B) Transverse cervical artery
(C) Thyrocervical trunk
(D) Costocervical trunk
(E) Ascending cervical artery

Back 4

D

Front 5

A 17-year-old boy receives an injury of the
phrenic nerve by a knife wound in the neck.
The damaged 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 brachial plexus
(D) Medial to the common carotid artery
(E) Superficial to the anterior scalene muscle

Back 5

E

Front 6

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?
(A) Ophthalmic division of the trigeminal
nerve
(B) Maxillary division of the trigeminal nerve
(C) Mandibular division of the trigeminal
nerve
(D) Facial nerve
(E) Auriculotemporal nerve

Back 6

A

Front 7

A 26-year-old singer visits her physician—
an ear, nose, and throat (ENT) surgeon—and
complains of changes in her voice. A laryngoscopic
examination demonstrates a lesion of
the superior laryngeal nerve, causing weakness
of which of the following muscles?
(A) Inferior pharyngeal constrictor
(B) Middle pharyngeal constrictor
(C) Superior pharyngeal constrictor
(D) Thyroarytenoid
(E) Thyrohyoid

Back 7

A

Front 8

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?
(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

Back 8

A

Front 9

young girl complains of dryness of the
nose and the palate. This would indicate a lesion
of which of the following ganglia?
(A) Nodose ganglion
(B) Otic ganglion
(C) Pterygopalatine ganglion
(D) Submandibular ganglion
(E) Ciliary ganglion

Back 9

C

Front 10

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?
(A) Sensory loss of the cornea and conjunctiva
(B) Lack of secretion of the parotid gland
(C) Absence of the corneal blink reflex
(D) Absence of sweating on the face
(E) Inability to constrict the pupil

Back 10

C

Front 11

A 39-year-old woman presents to your
clinic with complaints of headache and dizziness.
She has an infection of a cranial dural sinus;
one that lies in the margin of the tentonum
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?
(A) Straight sinuses
(B) Inferior sagittal sinus
(C) Sphenoparietal sinus
(D) Superior petrosal sinuses
(E) Cavernous sinus

Back 11

D

Front 12

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?
(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)

Back 12

E

Front 13

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?
(A) Trigeminal nerve
(B) Facial nerve
(C) Vagus nerve
(D) Spinal accessory nerve
(E) Hypoglossal nerve

Back 13

C

Front 14

A 25-year-old man is involved in an automobile
accident and slams his head into a concrete
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?
(A) Subarachnoid space
(B) Subdural space
(C) Epidural space
(D) Subpial space
(E) Cranial dural sinuses

Back 14

C

Front 15

A 27-year-old paratrooper lands on a pine
tree. Consequently, preganglionic parasympathetic
nerves leaving the central nervous system
are lacerated. Which of the following structures
contain cell bodies of the damaged nerve fibers?
(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

Back 15

E

Front 16

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?
(A) Trigeminal nerve
(B) Facial nerve
(C) Glossopharyngeal nerve
(D) Vagus nerve
(E) Hypoglossal nerve

Back 16

A

Front 17

A 67-year-old woman comes to her physician
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?
(A) Frontal sinus
(B) Maxillary sinus
(C) Ethmoid air cells
(D) Mastoid air cells
(E) Sphenoid sinus

Back 17

E

Front 18

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 most likely has been injured?
(A) Internal laryngeal nerve
(B) Lingual nerve
(C) Glossopharyngeal nerve
(D) Greater palatine nerve
(E) Chorda tympani

Back 18

C

Front 19

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 which of the
following bones?
(A) Frontal bone
(B) Ethmoid bone
(C) Temporal hone
(D) Basioccipital bone
(E) Sphenoid bone

Back 19

E

Front 20

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?
(A) Loss of sensation above the vocal cord
(B) Loss of lateral rotation of the arytenoid
cartilages
(C) Paralysis of vocalis muscle
(D) Lack of abduction of the vocal cord
(E) Decreased tension of the vocal cord

Back 20

E

Front 21

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?
(A) Straight sinus
(B) Cavernous sinus
(C) Superior petrosal sinus
(D) Sigmoid sinus
(E) Confluence of sinuses

Back 21

B

Front 22

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?
(A) Blindness
(B) Bitemporal (heteronymous) hemianopia
(C) Right nasal hemianopia
(D) Left homonymous hemianopia
(E) Binasal hemianopia

Back 22

B

Front 23

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?
(A) Vocalis muscle
(B) Cricothyroid muscle
(C) Oblique arytenoid muscle
(D) Posterior cricoarytenoid muscle
(E) Thyroarytenoid muscle

Back 23

D

Front 24

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?
(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

Back 24

B

Front 25

A 31-year-old woman complains of
headache and dizziness after hitting a kitchen
cabinet door with her head. Her magnetic resonance
imaging (MRT) 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?
(A) Emissary veins
(B) Pterygoid venous plexus
(C) Diploic veins
(D) Dural venous sinuses
(E) Internal jugular vein

Back 25

D

Front 26

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?
(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

Back 26

D

Front 27

53-year-old woman with a severe middle
ear infection comes to a hospital. On examination,
a physician finds the infection has injured
the tympanic nerve. The damaged 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

Back 27

D

Front 28

A 13-year-old boy competing in a motocross
competition falls from his bicycle and
sustains massive head injuries. 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

Back 28

B

Front 29

A 32-year-old house painter suffers from a
head injury after falling off a ladder and 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?
(A) Vagus nerve
(B) Facial nerve
(C) Hypoglossal nerve
(D) Trigeminal nerve
(E) Glossopharyngeal nerve

Back 29

D

Front 30

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:
(A) Is located at the origin of the external
carotid artery
(13) Is innervated by the facial nerve
(C) Functions as a chemoreceptor
(D) Is stimulated by changes in blood pressure
(E) Communicates freely with the cavernous
sinus

Back 30

D

Front 31

During a game, a 26-year-old baseball
player is hit in the head by a baseball 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

Back 31

C

Front 32

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 would most likely be involved?
(A) Accessory nerve
(B) Trigeminal nerve
(C) Ansa cervicalis
(D) Facial nerve
(E) Glossopharyngeal nerve

Back 32

D

Front 33

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?
(A) Chorda tympani and tympanic nerve
(B) Trigeminal and facial nerves
(C) Auditory and vagus nerves
(D) Facial and auditory nerves
(E) Trigeminal and accessory nerves

Back 33

B

Front 34

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?
(A) Trochlear nerve
(B) Superior cervical ganglion
(C) Oculomotor nerve
(D) Ophthalmic nerve
(E) Abducens nerve

Back 34

B

Front 35

A pharyngeal (gag) reflex is the contraction
of the pharyngeal constrictor muscles 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?
(A) Trigeminal nerve
(B) Facial nerve
(C) Glossopharyngeal nerve
(D) Vagus nerve
(E) Hypoglossal nerve

Back 35

C

Front 36

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?
(A) Ciliary ganglion and oculomotor nerve
(B) Oculomotor nerve and long ciliary nerve
(C) Short ciliary nerves and ciliary ganglion
(D) Superior cervical ganglion and long ciliary
nerve
(E) Oculomotor, trochlear, and abducens
nerves

Back 36

C

Front 37

A benign tumor in the orbit of 49-year-old
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?
(A) Frontal nerve
(B) Lacrimal nerve
(C) Trochlear nerve
(D) Abducens nerve
(E) Ophthalmic vein

Back 37

D

Front 38

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?
(A) Facial, glossopharyngeal, and hypoglossal
nerves
(B) Hypoglossal, vagus, and facial nerves
(C) Glossopharyngeal, trigeminal, and vagus
nerves
(D) Vagus, spinal accessory, and hypoglossal
nerves
(E) Facial, glossopharyngeal, and vagus
nerves

Back 38

A

Front 39

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?
(A) Right trigeminal nerve
(B) Left trigeminal nerve
(C) Right vagus nerve
(D) Left vagus nerve
(E) Left glossopharyngeal nerve

Back 39

C

Front 40

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?
(A) Inferior thyroid artery
(B) Inferior thyroid vein
(C) Costocervical trunk
(D) Superior thyroid artery
(E) Right brachiocephalic vein

Back 40

B

Front 41

59-year-old man complains of numbness
in the anterior cervical triangle. Damage has
therefore occurred to which of the following
nerves?
(A) Phrenic nerve
(B) Greater auricular nerve
(C) Transverse cervical nerve
(D) Supraclavicular nerve
(E) Lesser occipital nerve

Back 41

C

Front 42

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?
(A) Middle ethmoidal sinus
(B) Maxillary sinus
(C) Posterior ethmoidal sinus
(D) Anterior ethmoidal sinus
(E) Frontal sinus

Back 42

C

Front 43

Following a penetrated injury in the submandibular
triangle, the tongue of a 45-yearold
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 glossopharyngeal nerve

Back 43

D

Front 44

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?
(A) Tumor of the pituitary gland
(B) Occlusion of the posterior cerebral artery
(C) Infection in the maxillary sinus
(D) Infection in the cavernous sinus
(E) Tumor in the anterior cranial fossa

Back 44

D

Front 45

A young boy with a tooth abscess from a
long-standing 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?
(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

Back 45

D

Front 46

61-year-old woman is found to have ocular
lymphoma invading her optic canal.
Which of the following structures would most
likely be damaged?
(A) Ophthalmic vein
(B) Ophthalmic nerve
(C) Oculomotor nerve
(D) Trochlear nerve
(E) Ophthalmic artery

Back 46

E

Front 47

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?
(A) Inferior laryngeal nerves
(B) External carotid arteries
(C) Inferior thyroid veins
(D) Thyrocervical trunks
(E) Internal laryngeal nerves

Back 47

A

Front 48

A knife wound has severed the oculomotor
nerve in a 45-year-old man. Which of the following
conditions would occur because of this
injury?
(A) Constricted pupil
(B) Abduction of the eyeball
(C) Complete ptosis
(D) Impaired lacrimal secretion
(E) Paralysis of the ciliary muscle

Back 48

E

Front 49

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?
(A) Oculomotor nerves
(B) Trochlear nerves
(C) Trigeminal nerves
(D) Abducens nerves
(E) Hypoglossal nerves

Back 49

C

Front 50

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?
(A) Masseter muscle
(B) Stylopharyngeus muscle
(C) Anterior belly of the digastric muscle
(D) Buccinator muscle
(E) Tensor tympani

Back 50

D

Front 51

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?
(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 frontal bone

Back 51

C

Front 52

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
nerves leaving the skull. These nerves
leave the skull through which of the following
openings?
(A) Foramen spinosum
(B) Foramen rotundum
(C) Internal auditory meatus
(D) Jugular foramen
(E) Foramen lacerum

Back 52

D

Front 53

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?
(A) Vagus nerve and middle cervical ganglion
(B) Internal 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

Back 53

C

Front 54

54. 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?
(A) Superior thoracic artery
(B) fransverse cervical artery
(C) Ascending cervical artery
(D) Deep cervical artery
(E) Inferior thyroid artery

Back 54

D

Front 55

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?
(A) Optic nerve
(B) Long ciliary nerve
(C) Nasociliary nerve
(D) Zygomatic nerve
(E) Oculomotor nerveQ

Back 55

C

Front 56

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?
(A) Oculomotor nerves
(B) Abducens nerves
(C) Trochlear nerves
(D) Mandibular nerves
(E) Ophthalmic nerves

Back 56

D

Front 57

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?
(A) Palatine tonsil
(B) Pharyngeal tonsil
(C) Tubal tonsil
(D) Lingual tonsil
(E) Eustachian tonsil

Back 57

B

Front 58

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?
(A) Vagus and glossopharyngeal nerves
(B) Internal carotid and vertebral arteries
(C) Internal jugular vein and trigeminal nerve
(D) Facial and vestibulocochlear nerves
(E) Hypoglossal and accessory nerves

Back 58

D

Front 59

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?
(A) Levator labii superioris
(B) Zygomaticus minor
(C) Orbicularis oris
(D) Lateral pterygoid
(E) Depressor labii inferioris

Back 59

C

Front 60

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?
(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 sensation in the pharynx

Back 60

C

Front 61

A 71-year-old man suffers from a known
benign tumor in the pterygoid canal. Which
ofthe following nerve fibers could be injured
by this condition?
(A) Postganglionic parasympathetic fibers
(B) Taste fibers from the epiglottis
(C) General somatic afferent (GSA) fibers
(D) l'reganglionic sympathetic fibers
(E) General visceral afferent (GVA) fibers

Back 61

E

Front 62

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?
(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

Back 62

C

Front 63

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?
(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

Back 63

D

Front 64

A 12-year-old boy has difficulty in breathing
because he is choking on food. A school
nurse performs the Valsalva's 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?
(A) Rima glottidis
(B) Laryngeal vestibule
(C) Laryngeal ventricle
(D) Infraglottic cavity
(E) Piriform recess

Back 64

D

Front 65

A 59 year-old stroke patient is unable to
swallow because of a nerve injury. Which of the
following nerves is unaffected?
(A) Hypoglossal nerve
(B) Spinal accessory nerve
(C) Vagus nerve
(D) Facial nerve
(E) Trigeminal nerve

Back 65

B

Front 66

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 he paralyzed?
(A) Masseter muscle
(B) Medial pterygoid muscle
(C) Lateral pterygoid muscle
(D) Buccinator muscle
(E) Temporalis muscle

Back 66

C

Front 67

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?
(A) Orbicularis oculi
(B) Orbicularis oris
(C) Frontalis
(D) Levator palpebrae superioris
(E) Superior rectus

Back 67

D

Front 68

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?
(A) Ophthalmic nerve
(B) Mandibular nerve
(C) Maxillary nerve
(D) Optic nerve
(E) Trochlear nerve

Back 68

C

Front 69

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?
(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

Back 69

B

Front 70

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?
(A) Tarsal muscle
(B) Sphincter pupillae
(C) Dilator pupillae
(D) Ciliary muscles
(E) Orbitalis muscles

Back 70

D