Gross anatomy 205 midterm examination october 10, 1995

E. The pain associated with an increase in intracranial pressure causes a reflex constriction of the central artery of the retina.

able to suck more of the milkshake into my straw because I have stronger facial muscles, namely, the following pair:

B. buccinator and orbicularis oris.

C. platysma and zygomaticus major.

D. risorius and levator anguli oris.

E. depressor anguli oris and mentalis.
10. A teenage girl with acne was in the habit of picking at the

pimples on her face. As a result, one pimple located near the corner of

her mouth became infected. Within a few days the girl complained of a

bad headache and noticed a faint red streak that extended

subcutaneously from the infected pimple toward the medial angle of her

eye. Within a few days her condition worsened. She felt weak and

fatigued and showed signs of exophthalmos (bulging of the eye), ptosis

(drooping of the eyelid) and impairment of normal movements of the

eyeball on her left side. She finally consulted an ophthalmologist who

placed her immediately in the hospital and administered massive doses

of antibiotics to treat her meningitis. The following conclusions about

this girl's condition are true, except:

B. The facial vein, which has no valves, communicates with the dural venous sinuses through the ophthalmic vein.

C. The three cranial nerves supplying the extra ocular muscles pass through or along the wall of the cavernous sinus, thus explaining their involvement in her symptoms.

D. Her meningitis is due to the fact that the cavernous sinus drains directly into the transverse sinus.

E. Impairment of some sympathetic innervation can be expected because the internal carotid artery and its overlying plexus

of sympathetic fibers do course through the cavernous sinus.

which penetrates into the substance of his parotid gland. In the

Emergency Room you would look for damage to the following structures,

except:
A. external carotid artery.

B. great auricular nerve.

C. facial nerve.

D. retromandibular vein.

E. mental nerve

14. The following areas of mucous membrane are innervated by the named

nerve, except:

B. posterior nasal septum - nasopalatine nerve. most of the hard

palate - lesser (posterior) palatine nerve.

C. vestibular folds (false vocal cords) - internal laryngeal

nerve.

E. frontal sinus - supraorbital nerve.

interview as a resident. Take-off is quite painful for you because your

stuffed-up auditory tube makes equalizing pressure in you middle ear

difficult. To take your mind off the discomfort during landing you try

to remember the names of the muscles which, because of their attachment

to the auditory tube, could help equalize middle ear pressure. As your

ears "pop," you remember that these are the muscles, with one

exception. Indicate that exception.

B. tensor palati.

C. tensor tympani.

D. stapedius.

E. salpingopharyngeus.
16. Through the various foramina in the skull, structures enter and leave the cranial cavity. The following are correct statements, except:
A. The spinal and cranial components of the spinal accessory nerve enter the cranial cavity through the foramen magnum.

B. The middle meningeal artery enters the cranial cavity through the foramen spinosum.

C. Sensory information from the retina enters the cranial cavity through the optic canal.

D. Efferent fibers of the twelfth cranial nerve leave the cranial cavity by passing through the hypoglossal canal.

E. Blood in the dural sinus system leaves the cranial cavity by passing through the jugular foramina.
17. The following muscular attachments are correct, except:
A. superior constrictor - pterygomandibular raphe.

B. buccinator - pterygomandibular raphe.

C. middle constrictor - thyroid cartilage.

D. inferior constrictor - cricoid cartilage.

E. musculus uvulae - hard palate.
18. As an academic physician you discover the first case of an hypertrophied annul us tendineus which compresses those structures

which pass through it. You expected and found symptoms of malfunction of the following nerves, except:

B. trochlear nerve.

C. abducent nerve.

D. nasociliary nerve.

E. oculomotor nerve.

19. Each of the following statements regarding muscle action is correct, except:

B. the lateral rectus muscles abduct the eyeballs.

C. the stylopharyngeus elevates the larynx and pharynx during swallowing.

D. the genioglossus muscles protrude the tongue.

E. the mylohyoid muscles elevate the hyoid bone.
21. The following statements about the temporo-mandibular joint are correct, except:
A. As the jaw is opened the contraction of the medial pterygoid muscles pulls the mandible forward so that the articular disc

moves forward onto the articular tubercle of the temporal bone.

B. During closure of the mouth, the posterior fibers of the temporalis pull the mandible back into the mandibular fossa.

C. The digastrics, geniohyoid and mylohyoid muscles depress the jaw.

D. Elevation of the mandible involves contraction of the temporalis and masseter.

E. Lateral chewing movements are produced by alternating protruding and retracting each side of the mandible.

B. stapes and stapedius - second arch.

C. cricoid cartilage and cricothyroid - third arch.

D. posterior belly of digastric and stylohyoid - second arch.

E. tensor palati and tensor tympani - first arch
23. An aneurysm of either the posterior cerebral or superior cerebellar artery might very likely compress one or both of the following pair of nerves because they pass between these two arteries as they emerge from the brain:
A. vagus and glossopharyngeal.

B. abducens and vagus.

C. abducens and glossopharyngeal.

D. optic and oculomotor.

E. oculomotor and trochlear.
24. The following statements regarding the parasympathetic ganglia in the head are correct, except:
A. Fibers of the greater petrosal nerve synapse in the pterygopalatine ganglion.

B. Fibers of the deep petrosal nerve synapse in the pterygopalatine ganglion.

C. Fibers of the lesser petrosal nerve synapse in the otic ganglion.

D. Fibers of the chorda tympani nerve synapse in the submandibular ganglion.

E. Fibers running in the inferior division of the oculomotor nerve synapse in the ciliary ganglion.
25. Which of the following routes of the parasympathetic innervation to the eye is correct?
A. inferior division of the oculomotor - ciliary ganglion- short ciliary nerves - ciliary body and pupillary constrictor.

B. nasociliary nerve - ciliary ganglion- short ciliary nerves - ciliary body and pupillary dilator.

C. inferior division of the oculomotor - nasociliary nerve - ciliary ganglion- ciliary body.

D. superior division of the oculomotor - ciliary ganglion- long ciliary nerves - pupillary dilator.

E. nasociliary nerve - communicating branch to the ciliary ganglion- ciliary ganglion- infratrochlear nerve – arteries to the retina.
26. With respect to the skull of the newborn infant, the following statement(s) is(are) true:
1. The paranasal air sinuses are already formed.

2. The facial bony skeleton represents about the same percentage that the face comprises in the adult skull.

3. At birth the mandible is already a single bone.

4. The different bones of both the neurocranium and facial skeleton form by intramembranous or intracartilaginous bone formation.

2. courses on the promontory of the middle ear.

3. contains preganglionic fibers for the otic gang lion.

4. joins the lingual nerve.

infection or cancer may spread out of the pharynx. In "weak" regions of the pharynx, gaps occur in the constrictor muscle layer surrounding the

pharyngobasilar fascia. Regions where these gaps are found include:
1. at the base of the skull above the superior constrictor.

2. posterior to the cricothyroid joint.

3. in the bed of the palatine tonsil.

4. directly posterior to the hyoid bone.

2. back of the scalp - occipital nodes.

3. the middle ear - parotid nodes.

4. maxillary air sinus - submandibular nodes.

in the Emergency Room, you request a head X-ray, suspecting a blow-out fracture of the orbital floor. Which observation(s) would most directly

support your diagnosis?
1. the patient has a loose right incisor.

2. the patient is unable to look up with the right eye.

3. the patient has pain in the right ear.

4. the patient's right upper lip and lateral nose are numb.

indicated extra ocular muscle acting alone is(are):

2. Superior Oblique.

3. Inferior Rectus.

4. Inferior Oblique.

2. vestibulocochlear nerve - internal auditory meatus.

3. mandibular nerve - foramen rotundum.

4. middle meningeal artery - foramen spinosum.

penetrating knife cut in the side of his neck. In the Emergency Room you examine the patient and find that he has difficulty turning his

head to the left and shrugging his right shoulder. When asked to protrude his tongue it deviates to the right. From these symptoms you

conclude that the knife had damaged the following cranial nerve(s):

2. IX (glossopharyngeal).

3. XII (hypoglossal).

4. VII (facial).

2. supplies the stylopharyngeus muscle.

3. sends preganglionic fibers to the otic gang lion.

4. supplies sensory fibers to the carotid sinus.

2. third occipital nerve.

3. greater occipital nerve.

4. lesser occipital nerve.

39. During thyroidectomy the surgeon accidentally cuts the left recurrent laryngeal nerve. The symptom(s) resulting from this accident

include(s):

2. loss of sensation above the vocal chords.

3. a weakened cough.

4. a denervated cricothyroid muscle.

these vibrations.

the auditory tube. Pain associated with this condition is carried by what nerve? ______________________________ (be specific).

fibers is _____________________________.

48. You and your husband, who is a computer engineer, have your first baby. Your husband gets quite concerned every time the baby cries, he believes that she has a serious cold because her nose runs. As the physician in the family you point out that your baby doesn't have a cold, it's just that,her tears are transported to the nasal cavity through the ______________________ ducts.

49. All taste fibers in the chorda tympani nerve have their cell bodies in the _______________________ ganglion.

b. semimembranosus

c. long head of biceps femoris

d. short head of biceps femoris

e. popliteus
6. In addition to weakening flexion at the elbow joint, partial damage to the musculocutaneous nerve will also weaken
a. abduction of the arm

b. pronation of the forearm

c. supination of the forearm

d. abduction of the hand

e. adduction of the hand
7. Your patient is a major league baseball pitcher who comes to you complaining of pain in his right shoulder and difficulty in lifting the

arm over his head. Since damage to the "rotator cuff" is common in pitchers, you suspect damage to the tendon of the

b. supraspinatus

c. infraspinatus

d. teres minor

e. deltoid

10 - 12. A young woman is thrown from her horse while riding in the Santa Monica mountains. As she lands, the right side of her neck and

shoulder strike a fallen tree trunk. When you examine her several day later, you observe that her right arm hangs limply and is medially

rotated. Her forearm is pronated and she complains of numbness along the lateral side of her arm.

b. middle trunk

c. inferior trunk

d. medial cord

e. lateral cord
11. Because her arm is medially rotated, the nerve supply to which of the following was not completely damaged?
a. supraspinatus

b. infraspinatus

c. subscapularis

d. teres minor

e. deltoid
12. To account for the unopposed pronation of her forearm, which of the following muscles is paralyzed?
a. biceps brachii

b. triceps brachii

c. brachialis

d. coracoobrachialis

e. brachioradialis
13. When you stop your car suddenly to avoid a jogger, your right knee hits the dashboard with such force that the tibia is driven posteriorly

on the femur. You suspect ligament damage which, if not repaired, would make walking down stairs difficult. Which of the following

ligaments of the knee joint was torn?
a. patellar

b. anterior cruciate

c. posterior cruciate

d. tibial collateral

e. fibular collateral
18. In the hand, the four lumbrical muscles arise from tendons of the ______________________________ muscle, wind around the radial side of the fingers and insert into the tendons of the ______________________________ muscle.
19. Adduction of the fingers occurs at the ________________________ joints when the ___________________________ muscles contract.

Adduction of the thumb occurs at the ___________________________ joint when the ____________________________ muscle contracts.

these collateral channels are used to supply the upper limb.

25. You also try to compress the other artery as it passes behind the medial malleolus and enters the sole of the foot along with the tendons of the _____________________________________ and ____________________________ and ________________________ muscles.

1. Hyperacusia or excessive sensitivity to loud sounds results from damage to the

b. vestibulocochlear (VIII) nerve

c. glossopharyngeal (IX) nerve

d. tympanic membrane

e. cochlear membrane
2. Damage to the nerves passing through the foramen ovale would result in all of the following symptoms except
a. loss of taste sensation from the anterior two-thirds of the tongue

b. loss of general sensation from the floor of the oral cavity

c. loss of general sensation from the lower lip

d. reduced salivary secretions

e. weakness of soft palate movements during swallowing
3. Pressure on the oculomotor (III) nerve within the middle cranial fossa could result in all of the following symptoms except
a. loss of accommodation for near vision

b. pupillary dilation

c. lateral deviation of the eyeball

d. ptosis or drooping of the eyelid

e. loss of the corneal blink reflex
4. Local anesthetics injected midway along the posterior border of the sternocleidomastoid muscle produce a superficial cervical block. All of the following nerves would be anesthetized except
a. great auricular

b. greater occipital

c. lesser occipital

d. transverse cervical

e. supraclavicular
5. A tumor of the vestibulocochlear (VIII) nerve has compressed all of the structures in the internal auditory meatus and produced each of the following symptoms except
a. loss of hearing

b. nystagmus (involuntary eye movements)

c. loss of lacrimal secretion

d. difficulty in chewing

e. difficulty in swallowing
6. The paranasal sinus whose opening is in the poorest position for drainage when the head is held erect is the
a. frontal

b. sphenoid

c. maxillary

d. anterior ethmoid

e. posterior ethmoid
7. The intrinsic muscles of the larynx can be divided into two groups; 1) those concerned with protecting the larynx during swallowing, and 2)

those concerned with adjustments during phonation and respiration. A muscle of the first group is the

b. posterior cricoarytenoid

c. transverse interarytenoid

d. aryepiglotticus

e. vocalis
8. Infection of the middle ear can spread to surrounding areas by all of the following pathways except
a. through the tegmen tympani to the middle cranial fossa

b. through the medial wall to the labyrinth

c. through the floor to the internal jugular vein

d. through the aditus to the mastoid antrum and air cells

e. through the epitympanic recess to the internal auditory meatus
9. The temporomandibular joint usually dislocates anteriorly during yawning. Spasm of which muscles would cause the heads of the mandible

to dislocate anterior to the articular tubercles?

b. medial pterygoids

c. lateral pterygoids

d. masseters

e. temporalis
10. Most of the pain associated with a traumatic dislocation of the temporomandibular joint is carried by which nerve?
a. zygomaticotemporal branch of V2

b. auriculotemporal branch of V3

c. posterior auricular branch of VII

d. auricular branch of X

e. tympanic branch of IX
16. The cell bodies for the special sensory (taste) fibers which are located in the oropharynx are found in which of the following ganglia?
a. trigeminal (V)

b. geniculate (VII)

c. inferior ganglion of IX

d. inferior ganglion of X

e. both c. and d.
20. The only muscles which open the rima glottidis are the
a. cricothyroids

b. posterior cricoarytenoids

c. lateral cricoarytenoids

d. thyroarytenoids

e. interarytenoids
21. Each of the following neck muscles is innervated by anterior primary rami of cervical spinal nerves except the
a. posterior scalene

b. rectus capitis lateralis

c. longus colli

d. rectus capitis posterior major

e. middle scalene
22. When you ask your patient to protrude his tongue, it deviates to the right side. You immediately suspect paralysis of which muscle?
a. right styloglossus

b. right hyoglossus

c. right genioglossus

d. left genioglossus

e. left styloglossus
23. Sustained tension of the vocal cords is lost and the voice "tires easily" when which of the following muscles is paralyzed?
a. cricothyroid

b. posterior cricoarytenoid

c. lateral cricoarytenoid

d. thyroarytenoid

e. vocalis
24. Each of the following arteries is a branch of the internal carotid artery except
a. anterior cerebral

b. middle cerebral

c. posterior cerebral

d. posterior communicating

e. ophthalmic
25. During surgical removal of an impacted "wisdom" tooth, the right lingual nerve is severed inadvertently as it passes just below the

third mandibular molar. This patient would show ipsilateral loss of all of the following except

b. taste sensation from anterior two-thirds of tongue