Head & Neck 2 [Practice MC Questions]

The thyroid gland is located:

A. Superior to the thyroid cartilage

B. Posterior to the sternocleidomastoid

C. Between the cricoid cartilage and suprasternal notch

D. Inferior to the sternum

E. Lateral to the hyoid bone

C

T/F: The normal thyroid is visible upon examination and feels firm and nodular.

False

Which is the correct sequence for locating the thyroid cartilage and isthmus?

A. Chin → thyroid cartilage → cricoid cartilage → tracheal rings

B. Chin → cricoid cartilage → thyroid cartilage → tracheal rings

C. Chin → sternum → cricoid cartilage → thyroid cartilage

D. Chin → thyroid cartilage → suprasternal notch → tracheal rings

E. Cricoid cartilage → chin → tracheal rings → thyroid cartilage

A

A fluctuant midline neck mass that moves when swallowing or sticking out the tongue is most likely:

A. Thyroid adenoma

B. Thyroglossal duct cyst

C. Goiter

D. Branchial cleft cyst

E. Thyroid carcinoma

B

Statement I: Hypothyrodisim and Hyperthyroidism may present as a diffusely enlarged thyroid.

Statement II: Most thyroid nodules are malignant.

A. Both true

B. Both false

C. I true, II false

D. I false, II true

E. Neither applies

C

The duct associated with the parotid gland is:

A. Wharton's duct

B. Rivinus duct

C. Stensen's duct

D. Bartholin duct

E. Caruncle duct

C

The facial nerve runs between which parts of the parotid gland?

A. Isthmus and lobes

B. Deep and superficial lobes

C. Submandibular and sublingual lobes

D. Parotid and submandibular glands

E. Buccinator and masseter muscles

B

Which of the following may cause bilateral parotid swelling?

A. Bulimia

B. Alcoholism

C. Viral infection

D. Diabetes mellitus

E. All of the above

E

Purulent exudate expressed from Stensen's duct is most suggestive of:

A. Sialadenosis

B. Parotitis

C. Neoplasm

D. Leukoedema

E. TMJ disorder

B

Which is incorrect?

A. Parotid swelling → may occur with Sjögren's syndrome

B. Masseteric hypertrophy → may mimic parotid swelling

C. Stensen's duct opens opposite upper M1/M2

D. Bilateral parotid swelling is not caused by eating disorders

E. Parotid saliva should normally appear clear and watery

D

The submandibular gland drains into the oral cavity via:

A. Stensen's duct

B. Wharton's duct

C. Rivinus duct

D. Bartholin duct

E. Caruncle duct

B

Salivary stones are most common in which gland?

A. Parotid

B. Sublingual

C. Submandibular

D. Minor salivary glands

E. Lingual tonsils

C

Which structure marks the drainage site of the submandibular duct?

A. Sublingual caruncle

B. Plica fimbriata

C. Plica sublingualis

D. Bartholin's papilla

E. Lingual frenulum

A

T/F: Bimanual palpation (one hand under chin, one finger in mouth) is the best way to evaluate the submandibular and sublingual glands.

True

Which is the smallest of the major salivary glands?

A. Parotid

B. Submandibular

C. Sublingual

D. Buccal

E. Von Ebner's

C

Which duct is associated with the sublingual gland and opens into the submandibular duct?

A. Stensen's duct

B. Wharton's duct

C. Bartholin's duct

D. Rivinus duct

E. Minor duct

C

A mucocele results from:

A. Neoplasm of parotid gland

B. Torn/damaged salivary duct

C. Overgrowth of thyroid tissue

D. Obstruction of lymphatic vessel

E. TMJ dysfunction

B

Minor salivary glands are NOT found on:

A. Buccal mucosa

B. Labial mucosa

C. Soft palate

D. Gingiva

E. Tongue

D

Which condition describes a salivary gland duct rupture with fluid pooling beneath epithelium forming a small blister-like lesion?

A. Mucocele

B. Bulla

C. Parotitis

D. Angular cheilitis

E. Leukoedema

B

Approximately how many lymph nodes are found in the human neck?

A. 50

B. 100

C. 200

D. 300

E. 500

D

T/F: Normal lymph nodes are about 1 cm, soft, movable, and usually non-palpable.

True

Tender, warm, fluctuant lymph nodes are most consistent with:

A. Malignancy

B. Viral infection

C. Local infection

D. Congenital cyst

E. Metastasis

C

A fixed, firm, matted lymph node is most consistent with:

A. Reactive infection

B. Malignancy

C. Self-limiting viral process

D. Dental abscess

E. Sinusitis

B

Enlargement of the left supraclavicular lymph node (Virchow's node) may indicate:

A. Local tooth infection

B. Gastric cancer metastasis

C. TMJ disorder

D. Sinusitis

E. Thyroglossal duct cyst

B

Which is correct?

1. Submandibular nodes drain the oral cavity

2. Preauricular nodes drain the scalp

3. Supraclavicular nodes may reflect thoracic or abdominal pathology

A. 1 only

B. 1 and 2

C. 1 and 3

D. 2 and 3

E. 1, 2, and 3

E

Statement I: Lymphadenopathy in children is most commonly malignant.

Statement II: Lymphadenopathy in adults over 50 has a higher risk of malignancy.

A. Both true

B. Both false

C. I true, II false

D. I false, II true

D

A 40-year-old patient presents with a tender, enlarged lymph node at the angle of the mandible. Which clinical condition is most likely?

A. Gastric cancer metastasis

B. Tonsillar infection

C. TMJ disorder

D. Branchial cyst

E. Thyroid carcinoma

B

During lymph node exam, the sternocleidomastoid muscle is an important landmark for palpating:

A. Parotid duct

B. Thyroid isthmus

C. Submandibular gland

D. Anterior and posterior cervical nodes

E. Sublingual gland

D

Which of the following lymph node groups is palpated first during a systematic head and neck exam?

A. Submental nodes

B. Posterior auricular nodes

C. Preauricular nodes

D. Supraclavicular nodes

E. Submandibular nodes

C

A 55-year-old man presents with a firm, fixed cervical lymph node and weight loss. Which is the most appropriate next consideration?

A. Benign reactive lymphadenopathy

B. Malignant process

C. Viral infection

D. Congenital cyst

E. Dental abscess

B

The cricothyroid membrane lies between which two structures?

A. Thyroid cartilage and suprasternal notch

B. Thyroid cartilage and hyoid bone

C. Cricoid cartilage and tracheal rings

D. Thyroid cartilage and cricoid cartilage

E. Cricoid cartilage and sternum

D

T/F: A normal thyroid gland should slide upward when the patient swallows

True

The Stensen's duct passes:

A. Beneath the mylohyoid muscle and opens near the lingual frenulum

B. Over the masseter muscle, pierces the buccinator, and opens opposite M2

C. Along the floor of the mouth, opening into the sublingual caruncle

D. Into the submandibular duct near the plica sublingualis

E. Directly into the tonsillar crypts

B

1. Chewing movements of the mandible help massage the parotid gland.

2. This increases saliva transfer into the oral cavity.

A. 1 only

B. 2 only

C. 1 and 2

D. None

C

The plica fimbriata is:

A. A fold of mucosa along the floor of the mouth marking the sublingual gland

B. A small papilla opposite M1/M2 where Stensen's duct opens

C. Uneven mucosa texture on the underside of the tongue, normal variant

D. The largest sublingual duct joining the submandibular duct

E. A fibrous septum dividing submandibular lobes

C

The Rivinus ducts:

A. Are multiple small ducts of the sublingual gland opening along the sublingual fold

B. Represent the major submandibular duct opening at the caruncle

C. Are associated with the parotid gland

D. Drain minor glands in the buccal mucosa

E. Always join Bartholin's duct before entering oral cavity

A

Minor salivary glands are found in all the following sites except:

A. Buccal mucosa

B. Labial mucosa

C. Posterior palate

D. Dorsal tongue

E. Anterior hard palate

E

During lymph node palpation, which structure provides a firm backing for palpating cervical nodes?

A. Trapezius muscle

B. Mandibular condyle

C. Sternocleidomastoid muscle

D. Hyoid bone

E. Zygomatic arch

C

When palpating supraclavicular nodes, the examiner should:

A. Place thumbs in the suprasternal notch

B. Push fingers deeply behind the SCM

C. Push fingers over the clavicle using it as a firm backing

D. Place the patient in Trendelenburg position

E. Always palpate from behind only

C

T/F: A systematic lymph node exam should always begin at the same location for consistency and repeatability.

True