A 27-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. Nasociliary n
b. Maxillary division of the trigeminal nerve.
c. Mandibular division of the trigeminal nerve.
d. Facial nerve.
e. Auriculotemporal nerve
2. 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. Absence of the corneal blink reflex- paralysis of the orbicularis oculi m
c. Lack of secretion of the parotid gland
d. Absence of sweating on the face
e. Inability to contrict the pupil
3. A patient is involved in a bar fight and suffers a 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 accomodation
e. Internal strabismus (medial deviation)- lesion of CNVI which innervates the lactus rectus m and abducts the eyeball.
4. 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?
5. A CT reveals bleeding from the medial meningeal artery. The meninges has remained intact. Blood leaking from this artery enters which of the following spaces?
6. A 7-year-old boy 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. CNV via lingual nerve, a branch of mandibular division of CNV
7. After having a tonsillectomy, a 55-year-old tobacco chewer is unable to detect taste on the posterior one third of his tongue. Which of the following nerves has most likely been injured?
a. Lingual nerve
b. CN IX
c. Greater palatine nerve
d. Chorda tympani
8. A young boy has fractured his sella turcica after falling off his skateboard. This is probably due to fracture of which of the following bones?
9. Which of the following results from stimulation of the parasympathetic fibers to the eyeball?
a. Dilation of the pupil
b. Contraction of the ciliary muscle
c. Flattening of the lens
10. During a game, a 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 damaged?
a. Optic nerve and ophthalmic vein
b. Optic nerve and ophthalmic artery
c. Ophthalmic nerve and optic nerve
d. Ophthalmic artery and vein
11. Examination of the ear, nose and throat 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?
12. A pharyngeal (gag) reflex is the contraction of the pharyngeal constrictor muscles that is elicited by touching the back of a patient's pharynx (with a tongue depressor). Afferent nerve fibers that innervated the pharyngeal mucosa are branches of which of the following nerves?
13. A young 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 CNV
b. Left CNV
c. Right CNX
d. Left CNX
CNX innervates the musculus uvulae. A lesion causes deviation of the uvula toward the opposite side of the injury.
14. 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. CNX and middle cervical ganglion
b. Internal carotid artery and recurrent laryngeal nerve
c. Internal jugular vein and vagus nerve- also common and internal carotid arteries
d. Sympathetic trunk and common carotid artery
15. A 45-year-old woman has an infection localized to the cavernous sinus. Which of the following nerves would be unaffected by this condition?
a. Oculomotor nerve
b. Abducens nerve
c. Trochlear nerve
d. Mandibular nerve
16. A patient presents with a skull fracture on the lateral side of his head near the pterion. A head CT scan shows blood pooling just deep to and contained within the region of the parietal bone. After about 3 hours the patient begins to lose consciousness. What type of hematoma would you suspect in this patient?
a. Epidural hematoma due to a ruptured berry aneurysm (small sac-like ballooning of the vessel wall) of the anterior communicating artery
b. Epidural hematoma due to a torn middle meningeal artery
c. Sudural hematoma due to a torn bridging vein coursing from the cerebrum to a drual sinus.
d. Sudural hematoma due to a torn middle meningeal artery
1. 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 arytenoids cartilages
c. Paralysis of the vocalis muscle
d. Lack of abduction of the vocal cord
e. Decreased tension of the vocal cord
The superior thyroid artery is accompanied by the external laryngeal nerve, which innervates the cricothyroid muscle. Paralysis of this muscle due to a lesion of the external laryngeal nerve decreases tension of the vocal cord.
2. 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 (Jacobson's 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 CNIX
e. Forms the tympanic plexus in the external auditory meatus
3. A young singer 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 arytenoids muscle
d. Posterior cricoarytenoid muscle
e. Thyroarytenoid muscle
4. A 3-year-old male child complains of an earache. You suspect otitis media and prescribe an antibiotic. Children below the age of seven are more prone to otitis media because:
a. The inner ear is not well developed
b. The salpingopharyngeus muscle is much shorter
c. The Eustachian tube is shorter.
d. The Eustachian tube is longer
e. They are more prone to develop colds.
5. A 55-year-old woman is undergoing thryoidectomy. Two months postop she suffers from loss of sensation within the larynx from the vocal folds upwards to the entrance of the larynx, allowing for aspiration of liquids into the airway. Which of the following nerves is most likely injured?
a. Internal laryngeal nerve
b. External laryngeal nerve
c. Glossopharyngeal nerve
d. Hypoglossal nerve
e. Recurrent laryngeal nerve
6. A 52-year-old man is admitted to the emergency department with a bullet wound in the infratemporal fossa. During the physical examination it is observed that the patient has lost unilateral sensation of hot, cold, pain, and pressure from the front part of the tongue, but taste and salivary function are preserved. Which of the following is the most likely damaged?
a. CNVII was transected distal to the origin of the chorda tympani
b. Receptors for hot, cold, pain, and pressure are absent in the patient's tongue.
c. CNIX has been injured in the pharynx.
d. The superior laryngeal nerve was obviously severed by the bullet.
e. The lingual nerve was injured at its origin near the foramen ovale.
7. A 32-year-old man is admitted to the hospital with nausea, vomiting, and severe headache. An MRI reveals an acoustic neuroma. Which of the following nerves is most likely compressed by the tumor?
a. CNVII- a vestibuloschwannoma is a benign tumor of CNVIII, primarily the vestibular part. This usually causes compression of CNVII.