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  • Question 1 - An 11-year-old boy was brought to the emergency room due to fever and...

    Incorrect

    • An 11-year-old boy was brought to the emergency room due to fever and pain in the ears. Upon physical examination, it was observed that the mastoid area is erythematous and there is a presence of a boggy, tender mass. A diagnosis of acute mastoiditis was made. Which of the following parts of the temporal bone is most likely involved?

      Your Answer: Tympanic part

      Correct Answer: Petrous part

      Explanation:

      Mastoiditis is the inflammation of a portion of the temporal bone referred to as the mastoid air cells. The mastoid air cells are epithelium lined bone septations that are continuous with the middle ear cavity. The temporal bone is composed of four parts: the mastoid process, the petrous pyramid, the squamous, and tympanic portions. The mastoid process and the petrous pyramid are the portions of particular interest because of the prevalence of suppurations within these parts of the temporal bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14.7
      Seconds
  • Question 2 - Thyroid cancer has spread to the regional lymph nodes of a patient as...

    Incorrect

    • Thyroid cancer has spread to the regional lymph nodes of a patient as seen in a staging CT scan. The lymph from the thyroid gland will drain directly to which of the following nodes?

      Your Answer: Jugulodigastric lymph nodes

      Correct Answer: Deep lateral cervical lymph nodes

      Explanation:

      Lymphatic drainage of the thyroid gland involves the lower deep cervical, prelaryngeal, pretracheal, and paratracheal nodes. The paratracheal and lower deep cervical nodes, specifically, receive lymphatic drainage from the isthmus and the inferior lateral lobes. The superior portions of the thyroid gland drain into the superior pretracheal and cervical nodes.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      10.6
      Seconds
  • Question 3 - All of the muscles of the tongue (other than the palatoglossus) are innervated...

    Correct

    • All of the muscles of the tongue (other than the palatoglossus) are innervated by which of the following nerves:

      Your Answer: Hypoglossal nerve

      Explanation:

      All of the muscles of the tongue are innervated by the hypoglossal nerve, except for the palatoglossus, which is innervated by the vagus nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      7.2
      Seconds
  • Question 4 - Elevation of the mandible is produced primarily by which of the following muscles:...

    Correct

    • Elevation of the mandible is produced primarily by which of the following muscles:

      Your Answer: Temporalis, masseter and medial pterygoid

      Explanation:

      Elevation of the mandible is generated by the temporalis, masseter and medial pterygoid muscles.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      11.4
      Seconds
  • Question 5 - A patient complaining of loss of taste in the anterior 2/3 of the...

    Correct

    • A patient complaining of loss of taste in the anterior 2/3 of the tongue has most likely suffered damage to which nerve?

      Your Answer: Facial nerve

      Explanation:

      The hypoglossal nerve (CN XII) provides motor innervation to all of the intrinsic and extrinsic muscles of the tongue except for the palatoglossus muscle, which is innervated by the vagus nerve (CN X). It runs superficial to the hyoglossus muscle. Lesions of the hypoglossal nerve cause deviation of the tongue to the ipsilateral (i.e., damaged) side.Taste to the anterior two-thirds of the tongue is achieved through innervation from the chorda tympani nerve, a branch of the facial nerve (CN VII). General sensation to the anterior two-thirds of the tongue is by innervation from the lingual nerve, a branch of the mandibular branch of the trigeminal nerve (CN V3). The lingual nerve is located deep and medial to the hyoglossus muscle and is associated with the submandibular ganglion.On the other hand, taste to the posterior one-third of the tongue is accomplished through innervation from the glossopharyngeal nerve (CN IX), which also provides general sensation to the posterior one-third of the tongue.Taste perception also is performed by both the epiglottis and the epiglottic region of the tongue, which receives taste and general sensation from innervation by the internal laryngeal branch of the vagus nerve (CN X). Damage to the vagus nerve (CN X) causes contralateral deviation (i.e., away from the injured side) of the uvula.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      4.6
      Seconds
  • Question 6 - Lisa is a 75-year-old female rushed into the emergency department by first-aid responders....

    Correct

    • Lisa is a 75-year-old female rushed into the emergency department by first-aid responders. The ambulance team give a history of vomiting, homonymous hemianopia, weakness of the left upper and lower limb, and dysphasia. Lisa adds that she has a headache that keeps worsening. Lisa takes Warfarin as she is a known case of atrial fibrillation. Her INR is 4.3 despite the ideal target being 2-3. CT scan of the head suggests anterior cerebral artery haemorrhage. What areas of the brain are affected by an anterior cerebral artery stroke?

      Your Answer: Frontal and parietal lobes

      Explanation:

      The anterior cerebral artery supplies the midline portion of the frontal lobe and the superior medial parietal lobe of the brain. It also supplies the front four-fifths of the corpus callosum and provides blood to deep structures such as the anterior limb of the internal capsule, part of the caudate nucleus, and the anterior part of the globus pallidus. The cerebral hemispheres are supplied by arteries that make up the Circle of Willis. The Circle of Willis is formed by the anastomosis of the two internal carotid arteries and two vertebral arteries. Clinically, the internal carotid arteries and their branches are often referred to as the anterior circulation of the brain. The anterior cerebral arteries are connected by the anterior communicating artery. Near their termination, the internal carotid arteries are joined to the posterior cerebral arteries by the posterior communicating arteries, completing the cerebral arterial circle around the interpeduncular fossa, the deep depression on the inferior surface of the midbrain between the cerebral peduncles. The middle cerebral artery supplies part of the frontal, temporal and parietal lobes. The posterior cerebral artery supplies the occipital lobe.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      64.9
      Seconds
  • Question 7 - A 34 year old woman arrives at the clinic with a goitre and...

    Correct

    • A 34 year old woman arrives at the clinic with a goitre and is diagnosed with autoimmune thyroiditis. She is most likely to develop which of the following types of cancers?

      Your Answer: Lymphoma

      Explanation:

      Pre-existing chronic autoimmune (Hashimoto’s) thyroiditis is the only known risk factor for primary thyroid lymphoma and is present in approximately one-half of patients. Among patients with Hashimoto’s thyroiditis, the risk of thyroid lymphoma is at least 60 times higher than in patients without thyroiditis.

    • This question is part of the following fields:

      • Head & Neck
      • Pathology
      8.3
      Seconds
  • Question 8 - The posterior boundary of the carotid triangle is bounded by which of the...

    Incorrect

    • The posterior boundary of the carotid triangle is bounded by which of the following muscles?

      Your Answer: Anterior border of the trapezius muscle

      Correct Answer: Sternocleidomastoid

      Explanation:

      The carotid triangle is a portion of the anterior triangle of the neck. It is bounded superiorly by the posterior belly of the digastric muscle, antero-inferiorly by the superior belly of omohyoid and posteriorly by the sternocleidomastoid. The floor is formed by the thyrohyoid, hyoglossus, middle and inferior pharyngeal constrictors and the roof is formed by the skin, superficial fascia, platysma and deep fascia.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      19.4
      Seconds
  • Question 9 - The medial and lateral pterygoid muscles are innervated by which of the following...

    Correct

    • The medial and lateral pterygoid muscles are innervated by which of the following nerves:

      Your Answer: Mandibular division of the trigeminal nerve

      Explanation:

      Both the medial and lateral pterygoids are innervated by the mandibular division of the trigeminal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.3
      Seconds
  • Question 10 - A 19-year-old female presents to the oncology clinic after noticing a painless neck...

    Incorrect

    • A 19-year-old female presents to the oncology clinic after noticing a painless neck lump. On examination, she is noted to have bilateral thyroid masses and multicentric nodules near the base of the thyroid. Her corrected calcium level is 2.18 mg/dL. Which of the following is the most likely diagnosis?

      Your Answer: Sporadic medullary carcinoma of the thyroid

      Correct Answer: Medullary carcinoma of the thyroid associated with multiple endocrine neoplasia

      Explanation:

      Based on the aforementioned findings in this case, the most likely diagnosis is medullary carcinoma of the thyroid associated with multiple endocrine neoplasia (MEN). Medullary thyroid cancer is a tumour of the parafollicular cells (C cells) of the thyroid and is neural crest in origin. It may be familial and occur as part of the MEN 2A disease spectrum. Less than 10% of thyroid cancers are of this type with patients typically presenting as children or young adults. Diarrhoea occurs in 30% of the cases. In association with MEN syndromes, medullary thyroid cancers are always bilateral and multicentric. Spread may either be lymphatic or haematogenous, and as these tumours are not derived primarily from thyroid cells, they are not responsive to radioiodine. Toxic nodular goitre is very rare. In sporadic medullary carcinoma of the thyroid, patients typically present with a unilateral solitary nodule and it tends to spread early to the lymph nodes in neck.

    • This question is part of the following fields:

      • Head & Neck
      • Pathology
      24.6
      Seconds
  • Question 11 - Which one of the following muscles is innervated by the facial nerve? ...

    Correct

    • Which one of the following muscles is innervated by the facial nerve?

      Your Answer: Buccinator

      Explanation:

      Buccinator is a muscle of facial expression and is therefore innervated by the facial nerve. The lateral pterygoid, masseter, anterior belly of digastric and temporalis are all muscles of mastication and therefore innervated by the mandibular division of the trigeminal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      13.9
      Seconds
  • Question 12 - This anatomic part lies at the heart of the tooth. ...

    Correct

    • This anatomic part lies at the heart of the tooth.

      Your Answer: The pulp cavity

      Explanation:

      Within the central portion of the tooth lies the dental pulp. The pulp chamber provides mechanical support and functions as a barrier from external stimuli and the oral microbiome. The dental pulp is a unique tissue that is richly innervated and has an extensive microvascular network. Maintaining its vitality increases both the mechanical resistance of the tooth and the long-term survival. The junctional epithelium forms a band around the tooth at the base of the gingival sulcus, sealing off the periodontal tissues from the oral cavity.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      3.9
      Seconds
  • Question 13 - The left lateral pterygoid muscle is one of the muscles of mastication. When...

    Correct

    • The left lateral pterygoid muscle is one of the muscles of mastication. When acting alone, it will shift the mandible towards which direction?

      Your Answer: Laterally, to the right

      Explanation:

      The lateral pterygoid or external pterygoid is a muscle of mastication with two heads. It lies superiorly to the medial pterygoid. When acting alone, it will shift the mandible laterally and to the right.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      60.5
      Seconds
  • Question 14 - During thymectomy the surgeon accidentally nicks a vein that lies just posterior to...

    Incorrect

    • During thymectomy the surgeon accidentally nicks a vein that lies just posterior to the thymus. Which of the following vessels is likely to be injured?

      Your Answer: Right brachiocephalic vein

      Correct Answer: Left brachiocephalic vein

      Explanation:

      The thymus is located superficially in the anterior mediastinum. The left brachiocephalic vein courses through the mediastinum to join the right brachiocephalic vein and form the superior vena cava on the right side of the thorax. The left brachiocephalic vein, being superficial, courses just deep to the thymus so that it may be susceptible to compression by an adjacent tumour. The left pulmonary vein, left bronchial vein and right pulmonary artery are deep, and enter and exit the lung at its root, thus are not near the thymus. The right superior intercostal vein drains the 2nd to the 4th intercostal spaces and drains into the arch of the azygos vein. It is not, therefore, closely related with the thymus.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      28.5
      Seconds
  • Question 15 - Lateral medullary syndrome, also known as Wallenberg's syndrome is a neurological condition caused...

    Correct

    • Lateral medullary syndrome, also known as Wallenberg's syndrome is a neurological condition caused by ischaemia in the lateral part of the medulla oblongata and is commonly associated with numerous neurological symptoms. Which of the following arteries when occluded leads to this condition?

      Your Answer: Posterior inferior cerebellar

      Explanation:

      The lateral medullary syndrome or Wallenberg’s disease is also known as posterior inferior cerebellar artery syndrome (PICA). This syndrome is a clinical manifestation of the occlusion of the posterior cerebellar artery that results in symptoms of infarction of the lateral medullary oblongata. Other arteries that contribute to blood flow in to this region such are the vertebral artery, superior middle cerebellar and inferior medullary arteries can also result to this syndrome when occluded.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      23.5
      Seconds
  • Question 16 - A patient suffers a stab wound to the neck. The entry point of...

    Incorrect

    • A patient suffers a stab wound to the neck. The entry point of the blade is situated within the posterior triangle of the neck. Which of the following muscles is LEAST likely to be involved? Select ONE answer only.

      Your Answer: Anterior scalene

      Correct Answer: Sternohyoid

      Explanation:

      The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains: Muscles: thyrohyoid, sternothyroid, sternohyoid muscles Organs: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid gland Arteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteries Veins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veins Nerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerve The posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle. Contents: Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodes Nerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexus

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      17.1
      Seconds
  • Question 17 - In relation to the muscles of facial expression, It is true to say:...

    Correct

    • In relation to the muscles of facial expression, It is true to say:

      Your Answer: They are in the same subcutaneous plane as the platysma muscle

      Explanation:

      The facial muscles generally originate from the facial bones and attach to the skin, in the same plane as the platysma muscle. They are all innervated by cranial nerve VII (the facial nerve). The occipitofrontalis muscle consists of two parts: The occipital belly, near the occipital bone, and the frontal belly, near the frontal bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      3.6
      Seconds
  • Question 18 - A 30 year old welder presents to his family doctor with symptoms of...

    Correct

    • A 30 year old welder presents to his family doctor with symptoms of chronic ear discharge and a left-sided facial nerve palsy. On examination, he has foul smelling fluid draining from his left ear and a complete left-sided facial nerve palsy. What is the most likely cause?

      Your Answer: Cholesteatoma

      Explanation:

      A cholesteatoma consists of squamous epithelium that is trapped within the skull base and that can erode and destroy important structures within the temporal bone. They often become infected and can result in chronically draining ears. Treatment almost always consists of surgical removal. The majority (98%) of people with cholesteatoma have ear discharge or conductive hearing loss or both in the affected ear.Other more common conditions (e.g. otitis externa) may also present with these symptoms, but cholesteatoma is much more serious and should not be overlooked. If a patient presents to a doctor with ear discharge and hearing loss, the doctor should consider cholesteatoma until the disease is definitely excluded.Other less common symptoms (all less than 15%) of cholesteatoma may include pain, balance disruption, tinnitus, earache, headaches and bleeding from the ear. There can also be facial nerve weakness. Balance symptoms in the presence of a cholesteatoma raise the possibility that the cholesteatoma is eroding the balance organs in the inner ear.

    • This question is part of the following fields:

      • Head & Neck
      • Pathology
      16.1
      Seconds
  • Question 19 - The muscles of the soft palate (other than the tensor veli palatini) are...

    Incorrect

    • The muscles of the soft palate (other than the tensor veli palatini) are innervated by which of the following nerves:

      Your Answer: Glossopharyngeal nerve

      Correct Answer: Vagus nerve

      Explanation:

      All of the muscles of the soft palate are innervated by the vagus nerve (from the pharyngeal plexus), except for the tensor veli palatini, which is innervated by a branch of the mandibular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      15.1
      Seconds
  • Question 20 - Regarding the trachea, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding the trachea, which of the following statements is INCORRECT:

      Your Answer: A cricothyroidotomy is suitable for airway obstruction superior to the vocal folds.

      Correct Answer: A cricothyrotomy involves making an opening in the neck inferior to the cricoid cartilage.

      Explanation:

      A cricothyrotomy involves making an opening in the median cricothyroid ligament (the medial part of the cricothyroid membrane), between the cricoid cartilage below and the thyroid cartilage above.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      35.8
      Seconds
  • Question 21 - A 10-year-old develops tonsillitis and presents to the hospital in considerable pain. Which...

    Incorrect

    • A 10-year-old develops tonsillitis and presents to the hospital in considerable pain. Which among the following nerves carries the sensation from the tonsillar fossa?

      Your Answer: Vagus

      Correct Answer: Glossopharyngeal nerve

      Explanation:

      The glossopharyngeal nerve is the primary sensory nerve for the tonsillar fossa. The lesser palatine nerve makes a smaller contribution. Because of this, otalgia may occur following tonsillectomy.Anatomical Rationale:Each palatine tonsil has two surfaces, a medial surface which projects into the pharynx and a lateral surface that is embedded in the wall of the pharynx.The primary arterial supply is from the tonsillar artery, a branch of the facial artery. Its veins pierce the constrictor muscle to join the external palatine or facial veins. The external palatine vein is immediately lateral to the tonsil, which may result in bleeding during a tonsillectomy.Lymphatic drainage is the jugulodigastric node and the deep cervical nodes.TonsillitisThe inflammation of tonsils is usually due to bacterial aetiology (50%) – group A Streptococcus, the remainder of the causes are viral.May be complicated by the development of an abscess (quinsy), which may distort the uvula.Indications for tonsillectomy include recurrent acute tonsillitis, and enlargement causing sleep apnoea.Dissection tonsillectomy is the preferred technique with haemorrhage being the most frequent complication. Delayed otalgia may occur owing to irritation of the glossopharyngeal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14.5
      Seconds
  • Question 22 - Regarding the intervertebral disc, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the intervertebral disc, which of the following statements is CORRECT:

      Your Answer: Disc herniation most commonly occurs in the thoracic region.

      Correct Answer: In L4 - L5 disc herniation, the L5 spinal nerve root is the most commonly affected.

      Explanation:

      A posterolateral herniation of the disc at the L4 – L5 level would be most likely to damage the fifth lumbar nerve root, not the fourth lumbar nerve root, due to more oblique descending of the fifth lumbar nerve root within the subarachnoid space.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      35.5
      Seconds
  • Question 23 - A 42 - year old male patient with an acute onset headache was...

    Incorrect

    • A 42 - year old male patient with an acute onset headache was brought in to the emergency department with suspicion of a subarachnoid haemorrhage (SAH). The SHO on call decided to have a diagnostic lumbar puncture after computed topography scan failed to support the suspicion. To perform a successful lumbar puncture without causing injury to the spine, which anatomical landmark should guide the SHO to locate the fourth vertebra for insertion of the spinal needle?

      Your Answer: Umbilicus

      Correct Answer: Iliac crest

      Explanation:

      The safest spinal level for conducting a lumbar puncture, is at the level of the fourth lumbar vertebra. The anatomical landmark used to locate the fourth lumbar vertebra (L4), is the iliac crest. The needle can safely be inserted either above or below L4. The conus medullaris is at the level of the border of L1 and L2 so L4 is safely distant from it.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      50.5
      Seconds
  • Question 24 - Which of the following types best describe the epithelium on the external aspect...

    Incorrect

    • Which of the following types best describe the epithelium on the external aspect of the tympanic membrane?

      Your Answer: Ciliated columnar

      Correct Answer: Stratified squamous

      Explanation:

      The external aspect of the tympanic membrane is lined by stratified squamous epithelium. Clinical correlation: Following middle ear infections, this type of epithelium can migrate into the middle ear through a perforated tympanic membrane.The ear is composed of three anatomically distinct regions: – External ear: Auricle is composed of elastic cartilage covered by skin. The lobule has no cartilage and contains fat and fibrous tissue. External auditory meatus is variable in length, measuring approximately 2.5cm long in fully grown children. Lateral third of the external auditory meatus is cartilaginous, and the medial two-thirds is bony. The greater auricular nerve innervates the region. The auriculotemporal branch of the trigeminal nerve supplies most of the external auditory meatus and the lateral surface of the auricle. – Middle ear: It is the space between the tympanic membrane and cochlea. The aditus leads to the mastoid air cells is the route through which middle ear infections may cause mastoiditis. Anteriorly the eustachian tube connects the middle ear to the nasopharynx. The tympanic membrane consists of an outer layer of stratified squamous epithelium, a middle layer of fibrous tissue and an inner layer of mucous membrane continuous with the middle ear. The chorda tympani nerve passes on the medial side of the pars flaccida. The glossopharyngeal nerve and pain innervate the middle ear. Thus, pain may radiate to the middle ear following tonsillectomy. – Ossicles:Malleus attaches to the tympanic membrane (the Umbo). Malleus articulates with the incus (synovial joint). Incus attaches to stapes (another synovial joint). – Internal ear:It consists of the cochlea, semicircular canals, and vestibule. Organ of Corti is the sense organ of hearing and is located on the inside of the cochlear duct on the basilar membrane. Vestibule accommodates the utricle and the saccule. These structures contain endolymph and are surrounded by perilymph within the vestibule. The semicircular canals lie at various angles to the petrous temporal bone. All share a common opening into the vestibule.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      16.6
      Seconds
  • Question 25 - Where is the mental foramen located? ...

    Correct

    • Where is the mental foramen located?

      Your Answer: In the mandible

      Explanation:

      The mental foramen is found bilaterally on the anterior surface of the mandible adjacent to the second premolar tooth. The mental nerve and terminal branches of the inferior alveolar nerve and mental artery leave the mandibular canal through it.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      5.2
      Seconds
  • Question 26 - An 8 year old boy presents with bleeding from the nose. From which...

    Correct

    • An 8 year old boy presents with bleeding from the nose. From which area did the bleeding most likely originate?

      Your Answer: Kiesselbach's plexus

      Explanation:

      Answer: Kiesselbach’s plexusEpistaxis is defined as acute haemorrhage from the nostril, nasal cavity, or nasopharynx. The source of 90% of anterior nosebleeds within the Kiesselbach’s plexus (also known as Little’s area) on the anterior nasal septum. Kiesselbach’s plexus (Kiesselbach’s area or Little’s area) is a vascular region of the anteroinferior nasal septum that comprises four arterial anastomoses:1)anterior ethmoidal artery – a branch of the ophthalmic artery2)sphenopalatine artery

    • This question is part of the following fields:

      • Head & Neck
      • Pathology
      5
      Seconds
  • Question 27 - A 50-year-old male is planned for elective parotidectomy for pleomorphic adenoma. The surgeon...

    Correct

    • A 50-year-old male is planned for elective parotidectomy for pleomorphic adenoma. The surgeon intends to use a nerve integrity monitor thus avoiding neuromuscular blockade. Which of the following nerves is liable to injury in parotidectomy?

      Your Answer: Facial nerve

      Explanation:

      Parotidectomy is basically an anatomical dissection. Identification of the facial nerve trunk is essential during parotid gland surgery because facial nerve injury is the most daunting potential complication of parotid gland surgery owing to the close relation between the gland and the extratemporal course of the facial nerve. After exiting the stylomastoid foramen, the facial nerve enters the substance of the parotid gland and then gives off five terminal branches: From superior to inferior, these are the: – Temporal branch supplying the extrinsic ear muscles, occipitofrontalis and orbicularis oculi – Zygomatic branch supplying orbicularis oculi – Buccal branch supplying buccinator and the lip muscles – Mandibular branch supplying the muscles of the lower lip and chin – Cervical branch supplying platysma. There are two approaches to identify the facial nerve trunk during parotidectomy—conventional antegrade dissection of the facial nerve, and retrograde dissection. Numerous soft tissue and bony landmarks have been proposed to assist the surgeon in the early identification of this nerve. Most commonly used anatomical landmarks to identify facial nerve trunk are stylomastoid foramen, tympanomastoid suture (TMS), posterior belly of digastric (PBD), tragal pointer (TP), mastoid process and peripheral branches of the facial nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      21.1
      Seconds
  • Question 28 - The tensor villi palatini muscle is a broad thin, ribbon-like muscle in the...

    Incorrect

    • The tensor villi palatini muscle is a broad thin, ribbon-like muscle in the head that tenses the soft palate. Which of the following structures is associated with the tensor villi palatini muscle?

      Your Answer: The hamulus of the lateral pterygoid plate

      Correct Answer: The hamulus of the medial pterygoid plate

      Explanation:

      The pterygoid hamulus is a hook-like process at the lower extremity of the medial pterygoid plate of the sphenoid bone around which the tendon of the tensor veli palatini passes.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      22
      Seconds
  • Question 29 - A 5 year old boy is taken to the doctor by his father....

    Incorrect

    • A 5 year old boy is taken to the doctor by his father. He has had an earache for the past day and he is constantly pulling and touching his ear. His father noticed a foul smelling discharge leaking from his ear after which the earache resolved. Which of the following is the most likely cause?

      Your Answer: Otitis externa

      Correct Answer: Acute otitis media

      Explanation:

      Acute otitis media (AOM) is a painful type of ear infection. It occurs when the area behind the eardrum, the middle ear, becomes inflamed and infected.The following behaviours in children often mean they have AOM:- fits of fussiness and intense crying (in infants)- clutching the ear while wincing in pain (in toddlers)- complaining about a pain in the ear (in older children).Perforation of the tympanic membrane is not unusual as the process advances, most frequently in posterior or inferior quadrants. Before or instead of a single perforation, an opaque serum like exudate is sometimes seen oozing through the entire tympanic membrane.With perforation and in the absence of a coexistent viral infection, the patient generally experiences rapid relief of pain and fever. The discharge initially is purulent, though it may be thin and watery or bloody; pulsation of the otorrhea is common. Otorrhea from acute perforation normally lasts 1-2 days before spontaneous healing occurs. Otorrhea may persist if the perforation is accompanied by mucosal swelling or polypoid changes, which can act as a ball valve.

    • This question is part of the following fields:

      • Head & Neck
      • Pathology
      6
      Seconds
  • Question 30 - Regarding the hard palate, which of the following statements is CORRECT: ...

    Correct

    • Regarding the hard palate, which of the following statements is CORRECT:

      Your Answer: Lymphatic vessels from the palate usually drain into deep cervical lymph nodes.

      Explanation:

      Lymphatic vessels from the pharynx and palate drain into the deep cervical lymph nodes.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      21.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (13/25) 52%
Head & Neck (16/30) 53%
Pathology (3/5) 60%
Passmed