HEAD AND NECK SELF-EVALUATION EXAMINATION II.

By O.W. Henson, Jr., Ph.D.

University of North Carolina, Chapel Hill

Note that many of these questions may cover material that we have not discussed. Concentrate only on questions on material we have covered.

Each question consists of a stem accompanied by several statements. Each statement is treated as a separate question. Mark the correct statement(s) True (T) or False (F).

The olfactory nerves contain fibers:

_____ 1. whose cell bodies lie in the olfactory bulb.

_____ 2. which pass through the cribriform plate of the ethmoid bone.

_____ 3. which are distributed to the olfactory mucosa on the nasal septum and on the superior nasal concha.

The right optic nerve:

_____ 4. contains fibers whose cell bodies lie in the retina.
_____ 5. contains fibers which do not cross in the optic chiasma.
_____ 6. is surrounded by cerebrospinal fluid and all three layers of the meninges.
_____ 7. passes through the optic canal in company with the ophthalmic artery.

The oculomotor nerve:

_____ 8. supplies all of the extraocular muscles except the superior oblique,

lateral rectus and levator palpabrae superioris.
_____ 9. is the only cranial nerve arising from the dorsal surface of the brain.
_____ 10. contains parasympathetic fibers concerned with pupillary constriction.
_____ 11. passes through the superior orbital fissure.
_____ 12. in passing through the middle cranial fossa lies in the lateral wall of the cavernous sinus.

The trochlear nerve:

_____ 13. innervates the superior oblique muscle.
_____ 14. is the only nerve supplying the extraocular muscles which does not pass

through the common tendinous ring of the extraocular muscles.
_____ 15. passes along the medial wall of the cavernous sinus.
_____ 16. is the fourth cranial nerve.

The abducens nerve:

_____ 17. supplies only one extraocular muscle.

_____ 18. carries parasympathetic fibers.

_____ 19. if damaged, would be expected to lead to medial

deviation of the pupil and a resulting diplopia.

_____ 20. penetrates the dura in the posterior cranial fossa.

The trigeminal nerve:

_____ 21. is the only nerve supplying general sensation to the face.
_____ 22. has a motor root which supplies all the muscles of mastication.
_____ 23. leaves the brain stem at the junction of the pons and medulla.
_____ 24. contains parasympathetic fibers which supply the muscles of the tongue.

The ophthalmic nerve:

_____ 25. contains sensory fibers whose cell bodies lie in the trigeminal ganglion.
_____ 26. has a lacrimal branch which passes through the superior orbital fissure.
_____ 27. has a frontal branch which passes to the anterior part
of the scalp and supplies the frontalis muscle.
_____ 28. has a nasociliary branch which mediates all pain sensation from the eyeball.
_____ 29. contains fibers which innervate the tip of the nose.

The maxillary nerve:

_____ 30. has parasympathetic fibers, from the pterygopalatine ganglion,

traveling with some of its peripheral branches.

The mandibular nerve:

_____ 31. is the only branch of the trigeminal nerve which
contains motor fibers to striated muscle.
_____ 32. if blocked at the level of the foramen ovale, would be
expected to result in a numb lower lip, tongue and

cheek on the ipsilateral side.
_____ 33. has an auriculotemporal branch which carries
postganglionic parasympathetic fibers to the parotid gland.
_____ 34. has a lingual branch which carries parasympathetic fibers to the
submandibular and sublingual glands.
_____ 35. has a lingual branch which contains fibers whose cell
bodies lie in the geniculate ganglion and mediate
taste to the anterior two-thirds of the tongue.

The glossopharyngeal nerve:

_____ 36. leaves the skull through the jugular foramen.
_____ 37. supplies fibers for taste to the tongue.
_____ 38. supplies sensory fibers to the pharynx, and carotid
sinus and motor fibers to the stylohyoid muscle.

The vagus nerve:

_____ 39. contains afferent fibers mediating pain sensations
from the abdominal viscera.
_____ 40. has a superior laryngeal branch which is the main

sensory nerve of the larynx.
_____ 41. has a recurrent laryngeal branch which supplies all of
the intrinsic muscles of the larynx except the cricothyroid.
_____ 42. contains parasympathetic fibers which are distributed

to the ascending colon.

The accessory nerve:

_____ 43. supplies only two muscles, the sternocleidomastoid and trapezius.
_____ 44. has a spinal component, the fibers of which ascend
through the foramen magnum.
_____ 45. crosses the posterior triangle of the neck where is
runs into company with the external jugular vein.

The hypoglossal nerve:

_____ 46. supplies the intrinsic and extrinsic muscles of the tongue.
_____ 47. supplies the genioglossus muscle which is important as
a protruder of the tongue.
_____ 48. supplies the thyroglossus muscle which is an important
retractor muscle of the tongue.

Lymph nodes that receive lymph from various parts of the head include:

_____ 49. the submandibular nodes, near the gland of the same name.
_____ 50. the parotid nodes, near the gland of the same name.
_____ 51. the superficial cervical nodes, along the anterior jugular vein.
_____ 52. the deep cervical nodes, along the internal jugular vein.
_____ 53. the submental nodes, situated anteriorly on the

surface of the mylohyoid muscle.

The pterygomandibular raphe:

_____ 54. represent the junction of the superior constrictor and
the buccinator muscles.
_____ 55. forms one of the boundaries of the tonsillar fossa.
_____ 56. is stretched between the hamulus of the pterygoid
plate and the posterior part of the mylohyoid line.

The mandibular condyle:

_____ 57. lies in close relation to the external acoustic meatus.
_____ 58. is separated from the temporal bone by an articular disk.
_____ 59. lies in close relationship to the petrotympanic fissure.

The palatine tonsil:

_____ 60. is synonymous with adenoids.
_____ 61. is composed primarily of lymphatic tissue.
_____ 62. is supplied by a branch of the facial artery.
_____ 63. is situated between the medial and lateral glossoepiglottic folds.

With regard to the nose and paranasal sinuses:

_____ 64. only the frontal sinus is developed at birth.
_____ 65. the ethmoid cells primarily open into the inferior nasal meatus.
_____ 66. the sphenoid sinus is in close relation to the pituitary gland.
_____ 67. the middle nasal meatus receives lacrimal secretions
via the nasolacrimal duct.
_____ 68. the sensory supply to the nasal cavity is mediated by
branches of the ophthalmic and maxillary nerves.
_____ 69. the arterial supply is entirely by branches of the
external carotid and thus severe nose bleeds could be
expected to be halted by ligation of the external carotid artery.
_____ 70. the nasolacrimal duct and the duct of the frontal
sinus join before opening into the inferior nasal meatus.

The bony orbit of the adult:

_____ 71. has a relatively thin floor which also forms the roof
of the maxillary sinus.
_____ 72. is closely related medially, superiorly and inferiorly
to air-filled paranasal sinuses.
_____ 73. is composed of contributions from the frontal,
zygomatic, greater wing of the sphenoid, palatine and pterygoid bones.
_____ 74. has foramina on its medial wall which transmit
arteries to the mucous membrane of the nose.

The contents of the orbit include:

_____ 75. the ciliary ganglion which contain the cell bodies of sensory neurons.

_____ 76. the ophthalmic vein, which may receive blood from the face, and thus provides a pathway whereby

superficial infections may be carried to the orbit or cavernous sinus.

_____ 77. the lacrimal nerve, which contains sensory fibers
whose cell bodies lie in the trigeminal ganglion.
_____ 78. parasympathetic nerve fibers which pass through the
ciliary ganglion (without synapsing) and innervate the
muscles which constrict the pupil.
_____ 79. sympathetic fibers whose preganglionic cell bodies lie
in the upper thoracic portion of the spinal cord, and
whose postganglionic cell bodies lie in the
pterygopalatine ganglion.

The extraocular muscles consist of:

_____ 80. four rectus muscles, all of which arise from a common
tendinous ring in the region of the superior orbital fissure.
_____ 81. two oblique muscles which are innervated by the
trochlear and abducens nerves.
_____ 82. a levator palpebrae, superioris which is innervated by
the oculomotor nerve.
_____ 83. fibers of branchial arch origin.

With regard to the function of the extraocular muscles:

_____ 84. all except the levator palpebrae superioris cause
rotatory movements of the eyeball.
_____ 85. the superior oblique is the only muscle capable of
fully moving the pupil downward when the eye is initially adducted.
_____ 86. the lateral rectus is essential for full lateral

movement (abduction) of the pupil.

Transection of the right sympathetic trunk above level of the first thoracic ganglion would be expected to cause:

_____ 87. interruption of most of the afferent (pain) fibers
from the heart which travel with cervical sympathetic cardiac nerves.
_____ 88. ptosis of the upper eyelid on the right.
_____ 89. dilation of the right pupil.
_____ 90. vasoconstriction on right side of the face, neck and upper limb.
_____ 91. denervation of the sweat glands on the right side of the face.

The right optic nerve:

_____ 92. consists of fibers whose cell bodies are in the retina.
_____ 93. runs through the optic canal along with the ophthalmic artery and vein.
_____ 94. is surrounded by dura mater.
_____ 95. consists of fibers which course in the right and left optic tracts.
_____ 96. contains the central artery and vein of the retina.

_____ 97. is surrounded by cerebrospinal fluid.

_____ 98. passes through the common tendinous ring of origin or extraocular muscles.

KEY

The following numbered questions are True (T) :

2 36 76
3 37 77
4 40 80
5 41 82
6 42 84
7 43 85
10 44 86
11 46 88
12 47 91
13 49 92
14 50 94
16 51 95
17 52 96
19 53 97
20 54 98
21 56
22 57
25 58
26 59
28 61
29 62
30 66
31 68
32 71
33 72
34 74

35