HN exam 2

The hypoglossal nerve is both a motor and sensory nerve, and it innervates all of the muscles of the tongue EXCEPT the palatoglossus.

False

Which of the following is responsible for regulating homeostatic mechanisms?

Autonomic nervous system

The vagus nerve innervates all of the following structures EXCEPT

Nasal cavity

Where are the preganglionic parasympathetic neurons are located?

in the brainstem and in the lateral horns of spinal cord segments S2,

S3 and S4

Where are located the cell bodies of the postsynaptic (postganglionic)

sympathetic fibers to the head?

superior cervical ganglion

Chorda tympani carries preganglionic parasympathetic fibers for the

_______ gland

Sublingual

Postganglionic fibers reach the parotid gland by hitchhiking with which of the

following nerves?

Auriculotemporal

The _________ nerve carries preganglionic parasympathetic fibers into the otic ganglion

Lesser petrosal

Chorda tympani carries preganglionic parasympathetic and ___________

fibers

Taste

Preganglionic parasympathetic fibers running in the ____________reach the

lingual nerve

Chroda tympani

Horner’s syndrome would affect the ----

Dilator pupillae muscle

Which of the following cranial nerves does NOT carry preganglionic fibers in the head?

XI

Sympathetic fibers control the

Dilator pupillae muscle

The glossopharyngeal nerve (CN IX) is responsible for parasympathetic

innervation to the parotid gland, and taste to the anterior one-third of the tongue

False

The _______ division of CN ___ is responsible for our perception of balance and equilibrium

Vestibular VIII

Which of the following nerves may be responsible for this lady’s condition?

Left facial nerve

Inability to completely abduct the eye could be the result of an injur to which of the following cranial nerves?

VI

Which of the following nerve is not affected by cavernous sinus thrombosis?

V3

Herpes Zoster is a virus that produces painful vesicles in sensory territories. The lesion in this lady is in which nerve territory?

V2

The ophthalmic division of trigeminal nerve exits the skull through the ____, and supplies sensation to skin of the ____, while the maxillary division exits the skull through the ____, and supplies the _____

Superior orbital fissure, forehead, foramen rotundum, upper lip

A lesion of the trochlear nerve would result in weakness in moving the eyeball

Down and out

Which cranial nerve produces ptosis of the upper eyelid abducted and directed slightly inferiorly, dilation of the pupil, and unable to accommodate lens in the ipsilateral eye?

CN III

The olfactory nerves pass through the ____ and are responsible for out special sense of ____.

Cribiform plate, smell

CN I

Olfactory

CN II

Optic

CN III

Oculomotor

CN IV

Trochlear

CN V

Trigeminal

CN VI

Abducens

CN VII

Facial

CN VIII

Vestibulocochlear

CN IX

Glossopharyngeal

CN X

Vagus

CN XI

Accessory

CN XII

Hypoglossal

Which of the following nerved do not go through the superior orbital fissure?

II

Which of the following nerved do not exit through the jugular foramen?

XII

Which of the following nerved carries pain sensation from the cheek area

Buccal of V3

An acute inflammation of TMJ, which muscle is most likely affected?

Lateral pterygoid

Damage to the facial nerve near the stylomastoid foramen would likely cause these motor fuctions EXCEPT

Paralysis of the muscles of mastication

What major landmark is associated with the trigeminal nerve?

Foramen ovale

A patient protrudes the mandible and it deviates to the left, which muscle is responsible for protruding the mandible?

Right lateral pterygoid

Which of the following cranial nerve provides preganglionic parasympathetic input of the submandibular gland?

Facial

Which of the following branches of the trigeminal nerve is NOT responsible for sensory innervation to the skin?

Lingual

Which of the following vessels does the maxillary artery branch stem from?

External carotid

What blood vessels pass deep to this circled area?

Middle meningeal

A 47-year-old woman with a history of multiple sclerosis comes to her doctor complaining of sudden bursts (paroxysms) of pain in her mandible, especially in the lower lip, mandibular teeth, gingivae, and cheek on her right side. This debilitating pain is often triggered by eating, talking, or brushing her teeth and often gets worse as the day progresses. Which nerve is the source of her pain?

V3

A 13-year-old girl visits her pediatrician complaining of loss of sensitivity in her lower eyelid, the skin below her right eye, and in her upper lip and teeth. Which of the following sites is the most likely location for the nerve lesion responsible for these signs and symptoms?

Foramen rotundum

A patient comes to her dentist, complaining of burning on the anterior aspect of her tongue after drinking an extremely hot cup of coffee. Which cranial nerve is most likely responsible for the pain/chewing sensation?

Trigeminal

Which artery is the major blood supply to the hard palate?

greater palatine

The mental artery is a branch of which of the following arteries?

Inferior alveolar

Which one of the following arteries supply the maxillary molars?

Posterior superior alveolar

A cranial fracture through the foramen ovale is compressing a major nerve, thus affecting all the following muscles except,

Buccinator

Damage to the facial nerve near the stylomastoid foramen would likely cause each of the following motor deficits EXCEPT: 


Paralysis of the muscles that elevate the mandible

Cutting of the hypoglossal nerve in the hypoglossal canal would not interrupt the nerve supply to the:

Palatoglossus muscle

The teeth and gums separate the oral cavity proper from the:

Oral vestibule

Which structure forms one of the border of the tonsillar fossa for the palatine tonsils? 

Palatopharyngeal fold

To drain an abscess (a closed collection of pus) affecting the cheek area, an emergency room physician used local anesthesia for the surgery. Which of the following nerves must be anesthetized because it carries pain sensation from the cheek area?

Buccal (V3)

The lesser petrosal nerve carries preganglionic parasympathetic fibers to which of the following ganglion?

Otic

As a result of meningitis, a patient develops Bell's palsy. One of the signs is that the patient has difficulty closing forcefully the eyelids. What nerve was involved?

Facial

An 83-year-old male complains of achy jaws and a dark front tooth. Intraoral examination shows a darkened permanent maxillary right central incisor.  What nerves may be involved in the ache she feels in her jaw?

Mandibular (V3)

Postganglionic parasympathetic fibers innervating the sublingual gland are coming from which of the following ganglia?

Submandibular

Next to where would you observe salivation in the oral cavity when applying pressure to the submandibular gland?

Lingual frenulum

A 35-year-old woman comes to her dentist complaining of tenderness and pain in her right check next to the parotid gland, as well as bad breath and a foul-tasting mouth at meal time.  /a radio-opaque fluid is injected into the parotid duct system through cannulation, and this sialogaphy of the parotid duct confirms a blockage by a calculus (sialolith). What muscle, through which the parotid duct  passes is most likely causing the stenosis where the sialolith now resides, blocking the drainage of the parotid gland?

Buccinator

A 45-year-old man goes to his physician complaining of having trouble with his speech (dysarthria) and involuntary contractions (fasciculations) within his tongue muscles. The doctor notes that his tongue deviates to the right when the patient attempts to protrude his tongue, as seen in the figure. What nerve is most likely damaged in this patient?

Right hypoglossal nerve

Pain elicited from an infected facial wound is primarily conveyed by what nerve? 

Trigeminal

A 23-year-old female professional student wakes up with a facial nerve (CN VII or Bell) palsy. What muscle will continue to function despite this affliction?

Masseter

The surgical removal of a metastatic tumor in the infratemporal fossa caused an intense hemorrhage.  The surgeon clamped the main source of arterial supply to the area, which is the

Maxillary

During extraction of her impacted wisdom teeth, a 22-year-old woman suffers damage to her right inferior alveolar nerve.  Which of the following condition is most likely to result?

Paresthesia/numbness of the lower lip

A 59-year-old man with a herpes zoster infection within the mandibular division of the trigeminal nerve (CN V3) complains of  weakness when opening his mouth.  A comprehensive evaluation reveals that this problems are due to difficulty protruding the mandible,  and when protrusion is accomplished the mandible deviates to the left side.   What muscle is most likely weakened?

Lateral pterygoid

A 38-year-old patient complained of acute dental pain. The attending dentist found penetrating dental caries (dental decay) affecting one of the mandibular molar teeth. Which nerve would the dentist need to anesthetize to work on that tooth? 

Inferior alveolar

What cranial nerve provides preganglionic parasympathetics to the pterygopalatine ganglion?

Facial, CN VII

What nerve can be blocked by injecting anesthesia into the incisive foramen?

Nasopalatine

Which of the following nerve blocks is NOT related to any area of the maxillary nerve?

Mental

A 23-year-old female professional student wakes up with a facial nerve (CN VII) paralysis.  What muscle muscle will continue to function despite this affliction?

Masseter

Which one of the following openings communicate the pterygopalatine fossa with the infratemporal fossa?

pterygomaxillary fissure

The location of the otic ganglion is in the: 

Infratemporal fossa

A patient comes to her physician complaining of burning the anterior aspect of her tongue following drinking an extremely hot cup of coffee. Which cranial nerve is most likely responsible for the pain she is feeling?

Trigeminal

As part of an initial oral examination of a new patient, a dental hygienist inspects the vestibule of the mouth.  Which of the following structures is encountered in this area?

Opening of the parotid duct

Which muscle will not be affected when the mandibular division of the trigeminal nerve (V3) is anesthetized? 

Buccinator

The nerve which supplies sensory fibers to the submandibular gland is the

Lingual nerve

After the mandibular condyle is moved forward onto the articular eminence (e.g., by opening the mouth widely), what muscle can then retract the mandible?

Posterior part of temporalis m.

A patient is unable to taste a piece of sugar placed on the anterior part of the tongue. Which cranial nerve is most likely to have a lesion?

Facial nerve

Damage of the lingual nerve before it is joined by the chorda tympani in the infratemporal fossa would cause loss of:

general sensation to the anterior two thirds of the tongue

While recovering from a right facial paralysis, a 36-year-old female patient complained that food accumulated between the teeth and the cheek mucosa when chewing. The deficiency of which muscle was most likely the cause of the chewing problem?

Buccinator

The predominant muscle most associated with retraction of the mandible is the:

Temporalis

The pharyngeal tonsils, or adenoids, may become inflamed and in serious cases need to be removed. Where would the physician search for them?

In the roof of the nasopharynx

While recovering from multiple dental extractions, an elderly man experienced a radiating pain affecting the lower eyelid, lateral side of the nose, upper lip and over the zygomatic and temporal areas on the left side. Which nerve is involved in the patient's perception of pain?

Maxillary division of trigeminal

Inability to close the lips relates to the action of which of the following nerves?

Facial

During preparation to extract the right maxillary (upper) canine tooth, a dentist has difficulty anesthetizing this tooth and its associated gingivae. Therefore, the dentist administers a regional nerve block, depicted in the given photo, in which the anesthetic syringe needle penetrates the oral mucosa at the apex of the maxillary vestibule and is pushed beyond the roots of the teeth. Due to this injection, the patient experiences numbness and paresthesia within the upper canine and neighboring teeth, as well as the skin of the right inferior eyelid, cheek, lateral nose, and upper lip. What nerve was blocked and produced the described numbness?

Infraorbital

A 43-year-old man goes to his doctor complaining he is unable to close his right eye. His physical examination reveals an inability to wrinkle the right side of his forehead and asymmetry in his smile. Which of the following nerves is most likely damaged?

Facial nerve

A 42-year-old man suffers from a rare tongue disease and comes to the emergency department. On examination, he is unable to protrude his tongue. Which of the following muscles is paralyzed?

Genioglossus

As shown in the diagram, a 17-year-old woman presents with an anterior dislocation of her temporomandibular joint (TMJ). With her mandible stuck in the protruded (protracted) position, her dentist pulls the mandible inferiorly to enable the tone of a muscle to retrude (retract) the mandible to its normal position. Which muscle returns the mandibular condyle to its normal position after it clears the articular eminence?

Temporalis

During a domestic incident, a 28-year-old woman receives a vertical stab wound that lacerates the pterygomandibular raphe. As a result, which of the following muscles would be paralyzed?

Superior pharyngeal constrictor and buccinator muscles

During a fight between two construction workers, one man strikes the other with a hammer at the pterion of the skull. Which of the following bones may be fractured?

Greater wing of the sphenoid bone

A 24-year-old man came to his physician with a history of chronic maxillary sinusitis. A computed tomography (CT) scan reveals a soft-tissue mass in the superior aspect (or roof) of  the right maxillary sinus. Functional endoscopic sinus surgery (FESS) was performed to  biopsy the mass. Postoperatively, the patient experiences paresthesia and numbness of the skin of the right inferior eyelid and upper lip. Which nerve was most likely damaged during the surgery?

Infraorbital nerve

A 34-year-old man visits his physician complaining of abnormal sensations and numbness in his upper teeth and in the skin of his lower eyelid, cheek, upper lip, and lateral external nose on his left side. Which of the following cranial openings is the most likely site for the nerve lesion responsible for these signs and symptoms?

Foramen rotundum

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?

Maxillary nerve

What is the most likely anatomical reference to locate the opening of the parotid duct?

Mucosa of the cheek across the 2nd upper (maxillary) molar

A dentist prepares for an extraction of the second mandibular molar. To anesthetize the tooth, she injects a local anesthetic to block the mandibular division of the trigeminal nerve as it leaves the skull. What skull foramen is she targeting?

Foramen ovale