Chapter: Head & Neck
Topic: Pharynx
Subtopic: Passavant's ridge & palatal/pharyngeal muscles
Keyword definitions
Passavant's ridge — transient mucosal bulge on posterior pharyngeal wall during velopharyngeal closure.
Palatoglossus — muscle forming anterior faucial pillar; elevates posterior tongue and narrows oropharyngeal isthmus.
Superior constrictor — upper pharyngeal constrictor muscle assisting in pharyngeal peristalsis and velopharyngeal seal.
Salpingopharyngeus — elevates lateral pharyngeal wall and helps open Eustachian tube.
Palatopharyngeus — forms posterior pillar; elevates pharynx and helps close oropharyngeal isthmus.
Palatal aponeurosis — fibrous central sheet of soft palate formed by tensor veli palatini tendon.
Tensor veli palatini — tenses soft palate and opens auditory tube; innervated by V3.
Levator veli palatini — elevates soft palate; important for velopharyngeal closure.
Pharyngeal raphe — midline fibrous seam where constrictor muscles attach.
Pharyngeal plexus — nerve network providing motor (CN X) and sensory (CN IX) supply.
Lead Question - 2012
Passavants ridge is formed by ?
a) Palatoglossus
b) Superior constrictor
c) Salpingopharyngeus
d) Palatopharyngeus
Explanation (50 words): Passavant's ridge is a transient mucosal bulge on the posterior pharyngeal wall during swallowing and speech. It results primarily from contraction of the superior pharyngeal constrictor muscle, aiding velopharyngeal closure. Answer: b) Superior constrictor. This prevents nasal regurgitation and assists speech resonance during swallowing and phonation.
1. Which muscle forms the palatopharyngeal arch (posterior pillar)?
a) Palatoglossus
b) Palatopharyngeus
c) Levator veli palatini
d) Tensor veli palatini
Explanation: The palatopharyngeal arch is formed by palatopharyngeus covered with mucosa. It elevates the laryngopharynx and closes the oropharyngeal isthmus. Answer: b) Palatopharyngeus.
2. The motor supply of the superior pharyngeal constrictor is by?
a) Pharyngeal branch of vagus (pharyngeal plexus)
b) Glossopharyngeal nerve
c) Hypoglossal nerve
d) Facial nerve
Explanation: Superior constrictor receives motor innervation via the pharyngeal plexus from vagus (CN X). Glossopharyngeal provides sensory. Answer: a) Pharyngeal branch of vagus.
3. Which muscle elevates and widens the pharynx during swallowing?
a) Stylopharyngeus
b) Palatoglossus
c) Superior constrictor
d) Salpingopharyngeus
Explanation: Stylopharyngeus (supplied by CN IX) elevates and widens pharynx, aiding bolus passage. Answer: a) Stylopharyngeus.
4. Which muscle tenses the soft palate?
a) Tensor veli palatini
b) Levator veli palatini
c) Palatoglossus
d) Palatopharyngeus
Explanation: Tensor veli palatini tenses the soft palate and opens auditory tube, innervated by V3. Answer: a) Tensor veli palatini.
5. Which muscle primarily opens the pharyngeal orifice of the auditory tube?
a) Tensor veli palatini
b) Levator veli palatini
c) Salpingopharyngeus
d) Palatoglossus
Explanation: Tensor veli palatini actively opens the auditory tube during swallowing, equilibrating pressure. Answer: a) Tensor veli palatini.
6. Primary action of palatoglossus is to:
a) Elevate posterior tongue
b) Depress larynx
c) Tense soft palate
d) Open auditory tube
Explanation: Palatoglossus elevates posterior tongue and narrows oropharyngeal isthmus, supplied by pharyngeal plexus (CN X). Answer: a) Elevate posterior tongue.
7. The pharyngeal raphe is best described as:
a) Median fibrous seam where constrictors attach
b) Palatal aponeurosis continuation
c) Pharyngobasilar fascia thickening
d) Attachment of levator veli palatini
Explanation: The pharyngeal raphe is a midline fibrous seam where constrictors insert posteriorly. Answer: a) Median fibrous seam.
8. Which muscle originates from the palatal aponeurosis?
a) Tensor veli palatini
b) Levator veli palatini
c) Palatoglossus
d) Stylopharyngeus
Explanation: Palatoglossus originates from the palatal aponeurosis and descends to the tongue. Answer: c) Palatoglossus.
9. Palatoglossus receives its motor supply from:
a) Hypoglossal nerve
b) Vagus nerve via pharyngeal plexus
c) Glossopharyngeal nerve
d) Trigeminal nerve
Explanation: Unlike other tongue muscles, palatoglossus is supplied by vagus (CN X) via pharyngeal plexus. Answer: b) Vagus nerve.
10. Salpingopharyngeus primarily:
a) Elevates lateral pharyngeal wall and opens auditory tube
b) Depresses hyoid bone
c) Tenses the soft palate
d) Closes nasal cavity
Explanation: Salpingopharyngeus elevates lateral wall and assists in opening auditory tube, helping pressure balance. Answer: a) Elevates lateral pharyngeal wall and opens auditory tube.
Chapter: Head & Neck
Topic: Pharynx
Subtopic: Retropharyngeal space & related anatomy
Keyword definitions
Retropharyngeal space — potential space between buccopharyngeal fascia and alar fascia; pathway for infection spread.
Buccopharyngeal fascia — fascia covering outer surface of pharyngeal constrictors.
Alar fascia — layer separating retropharyngeal space from danger space posteriorly.
Danger space — space between alar and prevertebral fascia; infection can spread to mediastinum.
C7 vertebra — landmark near transition of cervical esophagus.
Bifurcation of trachea — occurs around T4–T5 level, carina of trachea.
Esophageal constrictions — natural narrowings: cricopharyngeal, aortic arch, left bronchus, diaphragmatic.
Prevertebral fascia — deep cervical fascia covering vertebral column and muscles.
Pharyngeal abscess — pus collection in retropharyngeal space, potentially life-threatening airway obstruction.
Mediastinitis — severe infection spreading into mediastinum, often from danger space.
Lead Question - 2012
Lower limit of retropharyngeal space is at ?
a) C 7
b) Bifurcation of trachea
c) 4 th esophageal constriction
d) None
Explanation (50 words): The retropharyngeal space extends from the base of the skull down to the level of T2 vertebra (around bifurcation of trachea). Below this, it continues as the danger space reaching the diaphragm. Answer: b) Bifurcation of trachea. Infections here may descend into mediastinum rapidly.
1. Which fascia forms the posterior boundary of the retropharyngeal space?
a) Buccopharyngeal fascia
b) Alar fascia
c) Prevertebral fascia
d) Investing fascia
Explanation: The retropharyngeal space is bounded anteriorly by buccopharyngeal fascia and posteriorly by alar fascia. Beyond alar fascia lies danger space and prevertebral fascia. Answer: b) Alar fascia. Clinical infections can breach this and spread rapidly to mediastinum causing acute mediastinitis, a life-threatening complication in deep neck infections.
2. Retropharyngeal abscess commonly arises from?
a) Dental infections
b) Middle ear infection
c) Upper respiratory tract infection
d) Cervical spine tuberculosis
Explanation: Retropharyngeal abscess usually follows upper respiratory tract infections in children due to suppuration of retropharyngeal lymph nodes, which regress after age 5. In adults, trauma or tuberculosis of cervical spine can cause it. Answer: c) Upper respiratory tract infection. Presents with fever, dysphagia, stridor, and bulging posterior pharyngeal wall.
3. Clinical danger of retropharyngeal space infection is?
a) Spread to mediastinum
b) Spread to parotid
c) Spread to orbit
d) Spread to mastoid
Explanation: Retropharyngeal infections may pass through alar fascia into danger space, which extends from skull base to diaphragm. This leads to mediastinitis with high mortality. Answer: a) Spread to mediastinum. Early recognition and surgical drainage are essential to prevent systemic sepsis and airway compromise in these cases.
4. The retropharyngeal space is directly anterior to:
a) Larynx
b) Trachea
c) Prevertebral fascia
d) Carotid sheath
Explanation: Retropharyngeal space lies between buccopharyngeal fascia covering pharynx and alar fascia, anterior to prevertebral fascia. Answer: c) Prevertebral fascia. Infections here may erode vertebral bodies or spread posteriorly to spinal epidural space. Imaging (CT/MRI) shows widening of this space in suspected deep neck infections in clinical practice.
5. In children, retropharyngeal abscess most often occurs due to suppuration of?
a) Pharyngeal tonsil
b) Retropharyngeal lymph nodes
c) Jugulodigastric nodes
d) Submandibular nodes
Explanation: Retropharyngeal lymph nodes drain nasopharynx, adenoids, posterior pharynx and are present until age 4–5. Infection of these nodes causes retropharyngeal abscess in children. Answer: b) Retropharyngeal lymph nodes. Presents with fever, torticollis, stridor. After age 5, such abscesses become uncommon because lymph nodes regress significantly.
6. Radiological sign of retropharyngeal abscess on lateral neck X-ray?
a) Widened prevertebral space
b) Air-fluid level
c) Straightened cervical lordosis
d) Calcification
Explanation: A widened prevertebral soft tissue shadow (>7 mm at C2 or >14 mm at C6 in children) suggests retropharyngeal abscess. Answer: a) Widened prevertebral space. Additional CT confirms pus collection. Clinically, respiratory distress with neck swelling mandates urgent ENT referral and surgical drainage along with antibiotics.
7. Which clinical symptom strongly suggests retropharyngeal abscess in a child?
a) Persistent cough
b) Trismus
c) Neck stiffness with noisy breathing
d) Ear discharge
Explanation: Child with fever, sore throat, neck stiffness, drooling, and inspiratory stridor strongly suggests retropharyngeal abscess. Noisy breathing results from airway narrowing. Answer: c) Neck stiffness with noisy breathing. Immediate airway assessment and imaging are life-saving. Delay can result in aspiration, septicemia, and airway collapse in severe cases.
8. Which deep neck space communicates with retropharyngeal space?
a) Parapharyngeal space
b) Carotid sheath
c) Submandibular space
d) Sublingual space
Explanation: Retropharyngeal space communicates laterally with parapharyngeal space, allowing infection spread between them. Answer: a) Parapharyngeal space. Clinically, this explains rapid progression of neck abscesses and potential involvement of carotid sheath structures when infections cross compartments. Imaging studies help map spread before surgical drainage intervention in hospital practice.
9. Which cervical level marks transition of retropharyngeal space into danger space?
a) C2
b) C6
c) T2
d) T4
Explanation: Retropharyngeal space ends at T2 level. Below this, it continues as danger space which extends to diaphragm. Answer: c) T2. This anatomical division is critical, since infections crossing this level rapidly descend into mediastinum, requiring aggressive management. Surgeons note this level during cervical deep space drainage procedures carefully.
10. Which structure lies anterior to retropharyngeal space?
a) Buccopharyngeal fascia and pharynx
b) Carotid sheath
c) Laryngeal cartilages
d) Trachea
Explanation: The retropharyngeal space is posterior to the pharynx, which is covered externally by buccopharyngeal fascia. Thus anterior boundary is formed by pharyngeal wall with buccopharyngeal fascia. Answer: a) Buccopharyngeal fascia and pharynx. Infection presents as posterior pharyngeal wall bulge clinically, visible on oral examination.
Chapter: Head & Neck
Topic: Pharynx
Subtopic: Killian’s dehiscence and constrictor muscles
Keyword definitions
Killian’s dehiscence — a weak area between thyropharyngeus and cricopharyngeus parts of the inferior constrictor, site of Zenker’s diverticulum.
Zenker’s diverticulum — pharyngoesophageal pouch protruding through Killian’s dehiscence causing dysphagia and regurgitation.
Inferior constrictor — lowest pharyngeal constrictor, with thyropharyngeus and cricopharyngeus parts.
Superior constrictor — pharyngeal muscle that aids velopharyngeal closure.
Middle constrictor — constrictor muscle arising from hyoid bone.
Pharyngeal plexus — motor supply from vagus nerve, sensory from glossopharyngeal.
Retropharyngeal space — potential space behind pharynx extending to mediastinum.
Esophageal constrictions — physiological narrowings: cricopharyngeal, aortic arch, left bronchus, diaphragm.
Cricopharyngeus — part of inferior constrictor, forms upper esophageal sphincter.
Thyropharyngeus — oblique part of inferior constrictor arising from thyroid cartilage.
Lead Question - 2012
Killian dehiscence is in ?
a) Superior constrictor
b) Inferior constrictor
c) Middle constrictor
d) None
Explanation (50 words): Killian’s dehiscence is a weak triangular gap between thyropharyngeus and cricopharyngeus fibers of the inferior constrictor muscle. It is the anatomical site where Zenker’s diverticulum develops, causing progressive dysphagia and aspiration risk. Answer: b) Inferior constrictor. This area is clinically important in esophageal surgery and ENT practice.
1. Zenker’s diverticulum arises from?
a) Between thyropharyngeus and cricopharyngeus
b) Between superior and middle constrictor
c) At cricoid cartilage
d) At hyoid bone
Explanation (50 words): Zenker’s diverticulum is a pulsion diverticulum occurring through Killian’s dehiscence, a weak area between thyropharyngeus and cricopharyngeus parts of the inferior constrictor. It leads to regurgitation of undigested food, chronic cough, and aspiration. Answer: a) Between thyropharyngeus and cricopharyngeus.
2. Cricopharyngeus muscle acts as?
a) Lower esophageal sphincter
b) Upper esophageal sphincter
c) Middle constrictor
d) Pharyngeal raphe
Explanation (50 words): Cricopharyngeus, the horizontal part of the inferior constrictor, functions as the upper esophageal sphincter. It relaxes during swallowing and contracts to prevent regurgitation of esophageal contents. Dysfunction causes dysphagia and predisposes to pharyngoesophageal diverticula. Answer: b) Upper esophageal sphincter.
3. Clinical feature of Zenker’s diverticulum?
a) Dysphagia
b) Hematemesis
c) Hemoptysis
d) Otalgia
Explanation (50 words): Zenker’s diverticulum presents with progressive dysphagia, regurgitation of undigested food, halitosis, nocturnal coughing, and aspiration pneumonia. It occurs through Killian’s dehiscence at the inferior constrictor. Answer: a) Dysphagia. It may mimic esophageal strictures clinically, but diagnosis is confirmed radiologically by barium swallow.
4. Nerve supply of inferior constrictor?
a) Glossopharyngeal
b) Vagus (via pharyngeal plexus & external/recurrent laryngeal nerves)
c) Hypoglossal
d) Accessory nerve
Explanation (50 words): Inferior constrictor is innervated by the vagus nerve via the pharyngeal plexus and additionally by external and recurrent laryngeal branches. This coordinated supply aids swallowing and sphincter function. Answer: b) Vagus (via pharyngeal plexus & external/recurrent laryngeal nerves).
5. Retropharyngeal abscess spreads into?
a) Mediastinum
b) Orbit
c) Mastoid air cells
d) Anterior triangle
Explanation (50 words): The retropharyngeal space extends from the base of skull to posterior mediastinum. Infections in this space, especially in children, can spread inferiorly and cause mediastinitis, a life-threatening condition. Answer: a) Mediastinum. Clinically, presents with fever, neck stiffness, dysphagia, and respiratory distress.
6. First esophageal constriction is at?
a) Cricopharyngeus
b) Aortic arch
c) Diaphragm
d) Left bronchus
Explanation (50 words): The esophagus has four constrictions: upper (cricopharyngeus at C6), aortic arch, left bronchus, and diaphragmatic hiatus. The first is at the cricopharyngeus, site of Killian’s dehiscence and common foreign body impaction. Answer: a) Cricopharyngeus.
7. Killian-Jamieson diverticulum arises from?
a) Lateral wall below cricopharyngeus
b) Posterior midline
c) Between middle and inferior constrictor
d) At aortic arch
Explanation (50 words): Killian-Jamieson diverticulum arises from the lateral wall of the cervical esophagus, just below the cricopharyngeus, unlike Zenker’s which is posterior. It is rare but can mimic Zenker’s clinically. Answer: a) Lateral wall below cricopharyngeus.
8. Best investigation for Zenker’s diverticulum?
a) Barium swallow
b) Endoscopy
c) CT neck
d) Ultrasound
Explanation (50 words): The diagnostic investigation of choice for Zenker’s diverticulum is barium swallow, which outlines the posterior pharyngoesophageal pouch. Endoscopy is avoided initially due to risk of perforation. Answer: a) Barium swallow.
9. Killian’s triangle is located?
a) Between thyropharyngeus & cricopharyngeus
b) Between superior & middle constrictor
c) Between middle & inferior constrictor
d) Between cricoid and trachea
Explanation (50 words): Killian’s triangle (dehiscence) is a weak posterior gap between oblique fibers of thyropharyngeus and horizontal fibers of cricopharyngeus, both parts of the inferior constrictor. Answer: a) Between thyropharyngeus & cricopharyngeus.
10. Common complication of untreated Zenker’s diverticulum?
a) Aspiration pneumonia
b) Pulmonary embolism
c) Otitis media
d) Carotid dissection
Explanation (50 words): Aspiration of regurgitated food from Zenker’s diverticulum leads to recurrent chest infections and aspiration pneumonia, the most common complication. Answer: a) Aspiration pneumonia. Chronic untreated cases may also cause malnutrition, halitosis, and rarely squamous carcinoma.
Chapter: Upper Limb
Topic: Nerve supply of hand
Subtopic: Cutaneous innervation of palm
Keyword definitions
Median nerve — supplies lateral palm, palmar aspect of lateral 3½ fingers, and dorsal tips of the same fingers.
Ulnar nerve — supplies medial 1½ fingers and medial palm and dorsum of hand.
Radial nerve — supplies dorsum of lateral hand, but no palmar branches.
Palmar cutaneous branch — arises from median and ulnar nerves, supplying central and medial palm.
Musculocutaneous nerve — supplies lateral forearm, not palm.
Carpal tunnel — passage for median nerve and flexor tendons beneath flexor retinaculum.
Guyon’s canal — fibro-osseous tunnel for ulnar nerve and artery at wrist.
Dermatomes — C6 supplies thumb, C7 middle finger, C8 little finger.
Thenar eminence — supplied by recurrent branch of median nerve.
Hypothenar eminence — supplied by deep branch of ulnar nerve.
Lead Question - 2012
Sensory supply of the palm is from which nerves -
a) Median nerve and Radial nerve
b) Radial nerve and Ulnar nerve
c) Ulnar nerve and Median nerve
d) Musculocutaneous nerve and Radial nerve
Explanation (50 words): The palm receives sensory innervation mainly from the median and ulnar nerves. Median nerve supplies the lateral 3½ digits and central palm, while ulnar nerve supplies the medial 1½ digits and medial palm. Radial nerve contributes dorsally only. Answer: c) Ulnar nerve and Median nerve.
1. Which nerve is compressed in carpal tunnel syndrome?
a) Ulnar nerve
b) Radial nerve
c) Median nerve
d) Musculocutaneous nerve
Explanation (50 words): Carpal tunnel syndrome results from compression of the median nerve beneath the flexor retinaculum. It causes tingling, numbness, and weakness in the lateral 3½ digits and thenar muscles. Ulnar and radial nerves are unaffected at this site. Answer: c) Median nerve.
2. Sensory loss over hypothenar eminence indicates damage to?
a) Median nerve
b) Ulnar nerve
c) Radial nerve
d) Axillary nerve
Explanation (50 words): The hypothenar eminence is supplied by the superficial branch of the ulnar nerve. Injury results in sensory loss over medial palm and little finger. Median nerve affects thenar eminence, radial nerve affects dorsum, and axillary nerve supplies shoulder region. Answer: b) Ulnar nerve.
3. Loss of sensation in thumb and index finger palmar aspect indicates lesion of?
a) Median nerve
b) Radial nerve
c) Ulnar nerve
d) Musculocutaneous nerve
Explanation (50 words): The median nerve supplies palmar aspect of thumb, index, middle finger, and radial half of ring finger. A lesion, especially at the wrist, produces sensory loss in these areas. Ulnar supplies medial fingers, radial dorsum, musculocutaneous forearm. Answer: a) Median nerve.
4. Which nerve injury causes sensory loss over dorsum of first web space?
a) Median nerve
b) Radial nerve
c) Ulnar nerve
d) Axillary nerve
Explanation (50 words): The superficial branch of radial nerve supplies dorsum of the first web space. Injury causes sensory loss here without motor deficit. This finding is pathognomonic of radial nerve involvement. Median and ulnar nerves do not supply this area, axillary supplies shoulder. Answer: b) Radial nerve.
5. In claw hand, sensory loss occurs mainly over?
a) Lateral 3½ fingers
b) Medial 1½ fingers
c) Palm center
d) Dorsum first web
Explanation (50 words): Claw hand results from ulnar nerve palsy, producing sensory loss over the medial 1½ fingers and medial palm. Median nerve lesions cause ape thumb and lateral finger sensory loss. Radial lesions affect dorsum, not palm. Answer: b) Medial 1½ fingers.
6. A patient with wrist laceration near pisiform loses sensation over medial palm. Which nerve is cut?
a) Median
b) Ulnar
c) Radial
d) Musculocutaneous
Explanation (50 words): Near pisiform, the ulnar nerve enters the hand via Guyon’s canal. Laceration here damages its superficial branch, producing sensory loss over medial palm and digits. Median nerve supplies lateral palm, radial dorsum, musculocutaneous forearm. Answer: b) Ulnar.
7. Which nerve gives palmar cutaneous branch before carpal tunnel, sparing central palm in CTS?
a) Ulnar nerve
b) Radial nerve
c) Median nerve
d) Musculocutaneous nerve
Explanation (50 words): The median nerve gives off a palmar cutaneous branch proximal to the carpal tunnel. Thus, in carpal tunnel syndrome, the central palm sensation is preserved, though digits are affected. Ulnar and radial also give palmar branches, but this clinical distinction is key for median nerve. Answer: c) Median nerve.
8. A knife injury at medial wrist leads to loss of finger abduction and sensory loss of medial palm. Which nerve is injured?
a) Median
b) Ulnar
c) Radial
d) Axillary
Explanation (50 words): The ulnar nerve supplies interossei (responsible for finger abduction/adduction) and sensory supply to medial palm. Damage at wrist causes motor and sensory loss as described. Median nerve supplies thenar, radial dorsum is radial, axillary shoulder. Answer: b) Ulnar.
9. Which nerve injury leads to loss of precision grip due to loss of thenar sensation and motor supply?
a) Median nerve
b) Ulnar nerve
c) Radial nerve
d) Musculocutaneous nerve
Explanation (50 words): The median nerve supplies thenar muscles (via recurrent branch) and lateral palm. Loss of sensation and motor control causes impaired precision grip, a hallmark of median nerve injury at wrist. Ulnar affects power grip, radial wrist extension, musculocutaneous forearm. Answer: a) Median nerve.
10. Which nerve supplies both dorsal and palmar surfaces of the medial 1½ fingers?
a) Median
b) Radial
c) Ulnar
d) Axillary
Explanation (50 words): The ulnar nerve supplies sensory innervation to medial 1½ fingers on both palmar and dorsal aspects. Median nerve covers lateral fingers, radial dorsum, axillary upper arm. Clinical lesions produce characteristic sensory loss over these areas. Answer: c) Ulnar nerve.
Chapter: Head & Neck Anatomy
Topic: Skull Bones
Subtopic: Ethmoid Bone and its parts
Keyword definitions
Ethmoid bone — An unpaired midline bone between the orbits forming part of the nasal cavity and orbit.
Agger nasi — Small prominence anterior to the middle turbinate, part of ethmoid labyrinth.
Crista galli — Superior midline projection of ethmoid giving attachment to falx cerebri.
Uncinate process — Thin bony process of ethmoid forming part of osteomeatal complex.
Inferior turbinate — A separate facial bone, not a part of ethmoid.
Olfactory foramina — Perforations in cribriform plate of ethmoid transmitting olfactory nerves.
Cribriform plate — Horizontal plate of ethmoid separating nasal cavity and anterior cranial fossa.
Ethmoidal air cells — Small paranasal sinuses within the ethmoid labyrinth.
Perpendicular plate — Part of ethmoid forming superior nasal septum.
Orbital plate — Part of ethmoid contributing to medial wall of orbit.
Lead Question - 2012
Which of the following is not the part of ethmoid bone?
a) Agger nasi
b) Crista galli
c) Uncinate process
d) Inferior turbinate
Explanation (50 words): Ethmoid bone contributes to nasal septum, orbit, and ethmoidal labyrinth. Agger nasi, crista galli, and uncinate process are all parts of the ethmoid. However, the inferior turbinate (concha) is a separate bone of the facial skeleton. Answer: d) Inferior turbinate.
1. Which structure of the ethmoid bone contributes to the formation of the nasal septum?
a) Cribriform plate
b) Crista galli
c) Perpendicular plate
d) Orbital plate
Explanation (50 words): The perpendicular plate of the ethmoid descends from the cribriform plate and forms the superior portion of the nasal septum. It articulates with the vomer and septal cartilage. Answer: c) Perpendicular plate.
2. A patient with anosmia following trauma most likely has fracture through which part of ethmoid?
a) Crista galli
b) Cribriform plate
c) Orbital plate
d) Perpendicular plate
Explanation (50 words): Olfactory nerves pass through the foramina of the cribriform plate. Fracture of this thin plate can shear the nerves, leading to anosmia and CSF rhinorrhea. Answer: b) Cribriform plate.
3. Which part of ethmoid bone gives attachment to falx cerebri?
a) Crista galli
b) Cribriform plate
c) Orbital plate
d) Uncinate process
Explanation (50 words): The crista galli is a vertical projection superiorly from the ethmoid bone. It provides anterior attachment for the falx cerebri, helping stabilize the brain within the cranial cavity. Answer: a) Crista galli.
4. Ethmoidal labyrinth contains:
a) Ethmoidal air cells
b) Sphenoidal sinus
c) Maxillary sinus
d) Frontal sinus
Explanation (50 words): The ethmoid labyrinth is composed of multiple thin-walled ethmoidal air cells, which open into the nasal cavity. They are classified as anterior, middle, and posterior groups. Answer: a) Ethmoidal air cells.
5. The medial wall of the orbit is formed partly by:
a) Orbital plate of ethmoid
b) Inferior turbinate
c) Perpendicular plate
d) Maxilla
Explanation (50 words): The lamina papyracea (orbital plate of ethmoid) forms a thin part of the medial orbital wall, making it prone to fractures and spread of sinus infection to the orbit. Answer: a) Orbital plate of ethmoid.
6. Which paranasal sinus lies within the ethmoid bone?
a) Ethmoidal sinus
b) Sphenoid sinus
c) Frontal sinus
d) Maxillary sinus
Explanation (50 words): The ethmoid bone contains the ethmoidal air cells, collectively referred to as ethmoidal sinuses. These are numerous small cavities within the ethmoid labyrinth. Answer: a) Ethmoidal sinus.
7. Agger nasi is related to which of the following?
a) Anterior ethmoidal cells
b) Sphenoethmoidal recess
c) Middle turbinate
d) Inferior turbinate
Explanation (50 words): The agger nasi is an anterior ethmoidal air cell lying just anterior to the attachment of the middle turbinate. It is an important landmark for endoscopic sinus surgery. Answer: a) Anterior ethmoidal cells.
8. A child with orbital cellulitis following sinusitis most likely has infection spread from:
a) Maxillary sinus
b) Ethmoidal sinus
c) Sphenoid sinus
d) Frontal sinus
Explanation (50 words): The lamina papyracea of the ethmoid forms a very thin medial wall of the orbit, allowing direct spread of infection from ethmoidal sinuses into the orbit. Answer: b) Ethmoidal sinus.
9. The structure passing through the anterior ethmoidal foramen is:
a) Anterior ethmoidal artery
b) Posterior ethmoidal nerve
c) Optic nerve
d) Nasociliary nerve
Explanation (50 words): The anterior ethmoidal artery, vein, and nerve pass through the anterior ethmoidal foramen to enter the nasal cavity and anterior cranial fossa. Answer: a) Anterior ethmoidal artery.
10. Which bone articulates with the ethmoid to form the nasal septum?
a) Vomer
b) Inferior turbinate
c) Zygoma
d) Palatine
Explanation (50 words): The vomer articulates inferiorly with the perpendicular plate of the ethmoid to form the bony part of the nasal septum. Answer: a) Vomer.
Chapter: Neuroanatomy
Topic: Cranial Nerves
Subtopic: Mandibular Nerve (V3) – Branches and Supply
Keyword definitions
Mandibular nerve (V3) — Third division of trigeminal nerve, mixed in function, carrying motor and sensory fibers.
Anterior division — Predominantly motor except for buccal nerve; supplies muscles of mastication (except medial pterygoid).
Posterior division — Mainly sensory, except nerve to mylohyoid which is motor.
Temporalis — Large fan-shaped muscle elevating and retracting mandible; supplied by deep temporal nerves (V3 anterior division).
Masseter — Powerful muscle for mastication; supplied by masseteric nerve (V3 anterior division).
Lateral pterygoid — Protracts mandible; supplied by nerve to lateral pterygoid (V3 anterior division).
Medial pterygoid — Elevates mandible; supplied by nerve to medial pterygoid (from main trunk of V3, not anterior division).
Buccal nerve — Sensory branch from anterior division of V3 supplying cheek mucosa and skin.
Nerve to mylohyoid — Motor branch from inferior alveolar nerve (posterior division) supplying mylohyoid and anterior digastric.
Otic ganglion — Small parasympathetic ganglion functionally related to V3, carrying fibers to parotid gland.
Lead Question - 2012
Which of the following is not supplied by the anterior division of mandibular nerve (V3)?
a) Temporalis
b) Medial pterygoid
c) Lateral pterygoid
d) Masseter
Explanation (50 words): The anterior division of V3 supplies temporalis, masseter, and lateral pterygoid muscles. The medial pterygoid, however, is supplied by the nerve to medial pterygoid, which arises directly from the main trunk of V3 before its anterior and posterior divisions. Answer: b) Medial pterygoid.
1. Which branch of the anterior division of mandibular nerve is purely sensory?
a) Deep temporal nerve
b) Buccal nerve
c) Masseteric nerve
d) Nerve to lateral pterygoid
Explanation (50 words): The buccal nerve is the only sensory branch from the anterior division of V3. It supplies sensation to the mucosa and skin of the cheek, while other branches are motor to muscles of mastication. Answer: b) Buccal nerve.
2. A patient with inability to protract the mandible likely has damage to:
a) Temporalis
b) Masseter
c) Lateral pterygoid
d) Medial pterygoid
Explanation (50 words): The lateral pterygoid is the only muscle of mastication responsible for protraction of the mandible. Damage to its nerve supply (nerve to lateral pterygoid from anterior division of V3) impairs forward movement of the jaw. Answer: c) Lateral pterygoid.
3. Which of the following muscles receives innervation from the nerve to medial pterygoid?
a) Tensor veli palatini
b) Lateral pterygoid
c) Temporalis
d) Masseter
Explanation (50 words): The nerve to medial pterygoid not only supplies the medial pterygoid muscle but also gives twigs to tensor tympani and tensor veli palatini. Answer: a) Tensor veli palatini.
4. Lesion of mandibular nerve at foramen ovale will produce all except:
a) Loss of sensation anterior 2/3 tongue (general)
b) Paralysis of temporalis
c) Loss of taste anterior 2/3 tongue
d) Paralysis of masseter
Explanation (50 words): Mandibular nerve carries general sensation but not taste from the anterior two-thirds of tongue (taste carried by chorda tympani via facial nerve). Hence taste is spared in V3 lesion. Answer: c) Loss of taste anterior 2/3 tongue.
5. The masseteric nerve passes through which structure to reach the masseter?
a) Foramen ovale
b) Mandibular notch
c) Pterygopalatine fossa
d) Infratemporal crest
Explanation (50 words): The masseteric nerve, branch of anterior division of V3, passes laterally through the mandibular notch to enter and supply the masseter muscle. Answer: b) Mandibular notch.
6. A fracture of mandibular condyle damaging the auriculotemporal nerve will cause:
a) Loss of taste
b) Loss of salivary secretion from parotid
c) Paralysis of masseter
d) Inability to protrude mandible
Explanation (50 words): Auriculotemporal nerve carries postganglionic parasympathetic secretomotor fibers from otic ganglion to the parotid gland. Injury reduces parotid secretion, not motor paralysis, as it is a sensory and secretomotor nerve. Answer: b) Loss of salivary secretion from parotid.
7. Which muscle of mastication lies in the temporal fossa and is innervated by deep temporal nerves?
a) Masseter
b) Temporalis
c) Lateral pterygoid
d) Medial pterygoid
Explanation (50 words): Temporalis is a large fan-shaped muscle in the temporal fossa, supplied by anterior and posterior deep temporal nerves from anterior division of V3. Answer: b) Temporalis.
8. Injury to lingual nerve before it is joined by chorda tympani will result in:
a) Loss of general and taste sensation
b) Loss of general sensation only
c) Loss of taste sensation only
d) Loss of salivary secretion only
Explanation (50 words): The lingual nerve carries general sensation from anterior 2/3 tongue. Before joining chorda tympani, it has no taste fibers. Therefore injury causes loss of general sensation only. Answer: b) Loss of general sensation only.
9. The mandibular nerve exits the skull through:
a) Foramen spinosum
b) Foramen ovale
c) Jugular foramen
d) Stylomastoid foramen
Explanation (50 words): The mandibular nerve passes through the foramen ovale to enter the infratemporal fossa where it divides into anterior and posterior divisions. Answer: b) Foramen ovale.
10. Which nerve supplies the mylohyoid and anterior belly of digastric?
a) Lingual nerve
b) Nerve to medial pterygoid
c) Nerve to mylohyoid
d) Buccal nerve
Explanation (50 words): The nerve to mylohyoid is a motor branch of the inferior alveolar nerve (posterior division of V3). It supplies the mylohyoid and anterior belly of digastric muscles. Answer: c) Nerve to mylohyoid.
Chapter: Neuroanatomy
Topic: Brainstem nuclei
Subtopic: Nucleus ambiguus
Keyword Definitions
Nucleus ambiguus: Motor nucleus in medulla supplying muscles of pharynx, larynx, and soft palate via CN IX, X, XI.
Cranial nerve IX (Glossopharyngeal): Provides motor fibers to stylopharyngeus and contributes to pharyngeal plexus.
Cranial nerve X (Vagus): Provides motor innervation to laryngeal and pharyngeal muscles.
Cranial nerve XI (Accessory): Cranial root joins vagus to supply pharyngeal and laryngeal muscles.
Cranial nerve XII (Hypoglossal): Purely motor, supplies intrinsic and extrinsic muscles of tongue, not nucleus ambiguus.
Lead Question - 2012
Nucleus ambiguus is not associated with which cranial nerve:
a) X
b) XI
c) IX
d) XII
Explanation: The nucleus ambiguus provides motor innervation via cranial nerves IX, X, and cranial part of XI, controlling swallowing and phonation. Cranial nerve XII (hypoglossal) arises from a separate hypoglossal nucleus, supplying tongue muscles. Hence, the correct answer is d) XII.
Guessed Question 1
A lesion of nucleus ambiguus leads to:
a) Loss of taste
b) Dysphagia
c) Loss of tongue movement
d) Loss of vision
Explanation: Nucleus ambiguus damage causes dysphagia due to paralysis of pharyngeal muscles. Taste is controlled by nucleus solitarius, and tongue movement by hypoglossal nucleus. Therefore, the correct answer is b) Dysphagia.
Guessed Question 2
The cranial root of accessory nerve joins which cranial nerve?
a) IX
b) X
c) XI
d) XII
Explanation: The cranial root of accessory nerve merges with the vagus nerve (X) after emerging from medulla and contributes to pharyngeal and laryngeal innervation. Hence, the correct answer is b) X.
Guessed Question 3
A patient with hoarseness and difficulty swallowing most likely has a lesion affecting:
a) Hypoglossal nucleus
b) Nucleus solitarius
c) Nucleus ambiguus
d) Oculomotor nucleus
Explanation: Hoarseness and dysphagia point to pharyngeal and laryngeal muscle involvement, which are supplied via motor fibers from nucleus ambiguus. Correct answer is c) Nucleus ambiguus.
Guessed Question 4
Stylopharyngeus muscle receives motor fibers from:
a) CN IX
b) CN X
c) CN XI
d) CN XII
Explanation: Stylopharyngeus is the only muscle supplied directly by glossopharyngeal nerve (IX), receiving motor input from nucleus ambiguus. Correct answer is a) CN IX.
Guessed Question 5
Which cranial nerve nucleus is purely motor and controls tongue muscles?
a) Nucleus ambiguus
b) Hypoglossal nucleus
c) Solitary nucleus
d) Dorsal motor nucleus of vagus
Explanation: The hypoglossal nucleus (CN XII) exclusively supplies intrinsic and extrinsic tongue muscles, unlike nucleus ambiguus. Correct answer is b) Hypoglossal nucleus.
Guessed Question 6
Nucleus ambiguus contributes to which reflex?
a) Gag reflex motor limb
b) Light reflex
c) Corneal reflex
d) Pupillary accommodation reflex
Explanation: The motor limb of gag reflex is mediated by vagus via nucleus ambiguus, while the sensory limb is by glossopharyngeal. Correct answer is a) Gag reflex motor limb.
Guessed Question 7
A lesion of vagus nerve involving nucleus ambiguus may cause:
a) Tongue deviation
b) Uvula deviation
c) Jaw deviation
d) Facial palsy
Explanation: Vagus supplies soft palate muscles. Unilateral lesion causes uvula to deviate away from affected side. Correct answer is b) Uvula deviation.
Guessed Question 8
Which muscle is not innervated by nucleus ambiguus?
a) Cricothyroid
b) Pharyngeal constrictors
c) Intrinsic laryngeal muscles
d) Soft palate muscles
Explanation: Cricothyroid is supplied by external branch of superior laryngeal nerve (CN X) but motor nucleus is not nucleus ambiguus. Correct answer is a) Cricothyroid.
Guessed Question 9
Damage to nucleus ambiguus bilaterally can cause:
a) Complete anarthria and aspiration
b) Diplopia
c) Ataxia
d) Loss of smell
Explanation: Bilateral lesions result in paralysis of pharynx and larynx, leading to anarthria and aspiration pneumonia risk. Correct answer is a) Complete anarthria and aspiration.
Guessed Question 10
Motor fibers of vagus nerve arise from:
a) Nucleus solitarius
b) Nucleus ambiguus
c) Dorsal motor nucleus
d) Spinal trigeminal nucleus
Explanation: Motor fibers for pharynx, larynx, and palate in vagus nerve originate from nucleus ambiguus. Dorsal motor nucleus carries parasympathetic fibers. Correct answer is b) Nucleus ambiguus.
Chapter: Head and Neck Anatomy
Topic: Arterial supply of Infratemporal Fossa
Subtopic: Maxillary Artery – Branches
Keyword Definitions
Maxillary artery: Terminal branch of external carotid artery, divided into three parts by lateral pterygoid muscle.
Middle meningeal artery: Branch of 1st part, supplies dura mater.
Accessory meningeal artery: Arises from 1st part, supplies cranial dura and trigeminal ganglion.
Inferior alveolar artery: Branch of 1st part, supplies mandible and lower teeth.
Greater palatine artery: Branch of descending palatine artery from 3rd part of maxillary artery, supplies hard palate.
Pterygoid part (2nd): Branches supply muscles of mastication.
Pterygopalatine part (3rd): Branches supply orbit, palate, and nasal cavity.
Lead Question - 2012
Which of the following is NOT a branch of 1st part of maxillary artery?
a) Middle meningeal artery
b) Accessory meningeal artery
c) Inferior alveolar artery
d) Greater palatine artery
Explanation: The 1st part of the maxillary artery gives middle meningeal, accessory meningeal, and inferior alveolar arteries. The greater palatine artery arises from descending palatine artery of 3rd part. Hence the correct answer is d) Greater palatine artery.
Guessed Question 1
The middle meningeal artery enters the cranial cavity through:
a) Foramen ovale
b) Foramen spinosum
c) Foramen rotundum
d) Jugular foramen
Explanation: Middle meningeal artery, branch of 1st part of maxillary artery, enters skull through foramen spinosum to supply dura. Injury causes extradural hematoma. Answer: b) Foramen spinosum.
Guessed Question 2
Inferior alveolar artery before entering mandibular foramen gives branch to:
a) Buccinator
b) Masseter
c) Mylohyoid
d) Temporalis
Explanation: The inferior alveolar artery gives the mylohyoid branch before entering mandibular foramen. It supplies mylohyoid and anterior belly of digastric. Correct answer: c) Mylohyoid.
Guessed Question 3
A fracture at pterion may rupture which artery?
a) Facial artery
b) Middle meningeal artery
c) Superficial temporal artery
d) Ascending pharyngeal artery
Explanation: Middle meningeal artery lies beneath pterion. Trauma causes rupture leading to extradural hematoma. Hence the correct answer is b) Middle meningeal artery.
Guessed Question 4
Accessory meningeal artery commonly enters cranium via:
a) Foramen spinosum
b) Foramen ovale
c) Foramen rotundum
d) Hypoglossal canal
Explanation: Accessory meningeal artery passes through foramen ovale to supply dura and trigeminal ganglion. Answer: b) Foramen ovale.
Guessed Question 5
A patient with bleeding from hard palate after trauma has injury to:
a) Middle meningeal artery
b) Inferior alveolar artery
c) Ascending pharyngeal artery
d) Greater palatine artery
Explanation: Greater palatine artery supplies hard palate through greater palatine foramen. Trauma can cause profuse bleeding. Answer: d) Greater palatine artery.
Guessed Question 6
Branches of 2nd part of maxillary artery mainly supply:
a) Dura mater
b) Muscles of mastication
c) Tongue
d) Nasal septum
Explanation: The pterygoid (2nd) part of maxillary artery mainly gives muscular branches to muscles of mastication. Correct answer: b) Muscles of mastication.
Guessed Question 7
Descending palatine artery is a branch of:
a) Facial artery
b) 3rd part of maxillary artery
c) Lingual artery
d) Ascending pharyngeal artery
Explanation: Descending palatine artery arises from 3rd (pterygopalatine) part of maxillary artery, divides into greater and lesser palatine arteries. Correct answer: b) 3rd part of maxillary artery.
Guessed Question 8
Extradural hematoma is classically due to rupture of:
a) Inferior alveolar vein
b) Middle meningeal artery
c) Anterior cerebral artery
d) Posterior communicating artery
Explanation: Rupture of middle meningeal artery due to skull fracture at pterion causes extradural hematoma, a neurosurgical emergency. Correct answer: b) Middle meningeal artery.
Guessed Question 9
Inferior alveolar artery after entering mandibular canal supplies:
a) Tongue
b) Lower teeth
c) Nasal cavity
d) Upper lip
Explanation: Inferior alveolar artery courses in mandibular canal to supply mandibular teeth and chin via mental branch. Correct answer: b) Lower teeth.
Guessed Question 10
Posterior superior alveolar artery, a branch of maxillary artery, supplies:
a) Lower premolars
b) Upper incisors
c) Maxillary molars
d) Mandibular molars
Explanation: Posterior superior alveolar artery supplies maxillary molars and adjacent gingiva. It is from 3rd part of maxillary artery. Correct answer: c) Maxillary molars.
Chapter: Head and Neck Anatomy
Topic: Autonomic Nervous System
Subtopic: Otic Ganglion – Location and Relations
Keyword Definitions
Otic ganglion: A parasympathetic ganglion located in the infratemporal fossa, associated with glossopharyngeal nerve.
Foramen ovale: Opening in sphenoid bone transmitting mandibular nerve.
Tensor veli palatini: Muscle of soft palate, medial to otic ganglion.
Mandibular nerve: Main trunk passes lateral to otic ganglion.
Middle meningeal artery: Artery from 1st part of maxillary artery, medial to otic ganglion.
Auriculotemporal nerve: Branch of mandibular nerve carrying secretomotor fibers from otic ganglion to parotid gland.
Glossopharyngeal nerve: Provides preganglionic parasympathetic fibers via lesser petrosal nerve to otic ganglion.
Parasympathetic ganglion: Collection of postganglionic neurons controlling glandular secretion.
Lead Question - 2012
All of the following are true about location of otic ganglia except:
a) Inferior to foramen ovale
b) Lateral to tensor veli palatini
c) Lateral to mandibular nerve
d) Anterior to middle meningeal artery
Explanation: The otic ganglion lies just inferior to foramen ovale, medial to mandibular nerve, and lateral to tensor veli palatini. It is medial, not anterior, to middle meningeal artery. Therefore, the incorrect statement is d) Anterior to middle meningeal artery.
Guessed Question 1
Preganglionic fibers reaching otic ganglion are derived from:
a) Auriculotemporal nerve
b) Chorda tympani
c) Lesser petrosal nerve
d) Facial nerve
Explanation: Preganglionic fibers from glossopharyngeal nerve travel via tympanic branch and lesser petrosal nerve to synapse at otic ganglion. Postganglionic fibers reach parotid gland through auriculotemporal nerve. Correct answer: c) Lesser petrosal nerve.
Guessed Question 2
Secretomotor fibers to parotid gland are carried by:
a) Lingual nerve
b) Buccal nerve
c) Auriculotemporal nerve
d) Inferior alveolar nerve
Explanation: Postganglionic parasympathetic fibers from otic ganglion are carried to the parotid gland by auriculotemporal nerve, a branch of mandibular nerve. Correct answer: c) Auriculotemporal nerve.
Guessed Question 3
A lesion in lesser petrosal nerve would affect secretion of:
a) Sublingual gland
b) Lacrimal gland
c) Submandibular gland
d) Parotid gland
Explanation: Lesser petrosal nerve carries parasympathetic fibers from glossopharyngeal nerve to otic ganglion, essential for parotid gland secretion. Lesion results in dry mouth due to parotid dysfunction. Correct answer: d) Parotid gland.
Guessed Question 4
The otic ganglion is functionally associated with:
a) Facial nerve
b) Hypoglossal nerve
c) Glossopharyngeal nerve
d) Vagus nerve
Explanation: Although anatomically attached to mandibular nerve, the otic ganglion is functionally linked with glossopharyngeal nerve via lesser petrosal branch. Correct answer: c) Glossopharyngeal nerve.
Guessed Question 5
Middle meningeal artery lies in relation to otic ganglion as:
a) Lateral
b) Medial
c) Anterior
d) Posterior
Explanation: The otic ganglion is located medial to the mandibular nerve and lateral to tensor veli palatini, with the middle meningeal artery lying medial to it. Correct answer: b) Medial.
Guessed Question 6
Which nerve carries postganglionic sympathetic fibers through otic ganglion without synapse?
a) Lesser petrosal nerve
b) Glossopharyngeal nerve
c) Auriculotemporal nerve
d) Facial nerve
Explanation: Sympathetic fibers from external carotid plexus pass through otic ganglion without synapsing and reach parotid gland via auriculotemporal nerve. Correct answer: c) Auriculotemporal nerve.
Guessed Question 7
The otic ganglion is located in which fossa?
a) Pterygopalatine fossa
b) Parapharyngeal space
c) Infratemporal fossa
d) Temporal fossa
Explanation: The otic ganglion lies in the infratemporal fossa, just below foramen ovale, closely related to mandibular nerve. Correct answer: c) Infratemporal fossa.
Guessed Question 8
Damage to auriculotemporal nerve after otic ganglion lesion would impair:
a) Lacrimal gland secretion
b) Parotid gland secretion
c) Submandibular gland secretion
d) Sublingual gland secretion
Explanation: Postganglionic fibers from otic ganglion to parotid are transmitted by auriculotemporal nerve. Injury leads to reduced parotid secretion. Correct answer: b) Parotid gland secretion.
Guessed Question 9
Which muscle lies medial to otic ganglion?
a) Masseter
b) Buccinator
c) Tensor veli palatini
d) Temporalis
Explanation: The otic ganglion lies lateral to tensor veli palatini muscle, which forms part of its medial relation. Correct answer: c) Tensor veli palatini.
Guessed Question 10
Which foramen transmits lesser petrosal nerve to otic ganglion?
a) Foramen rotundum
b) Foramen spinosum
c) Foramen ovale
d) Jugular foramen
Explanation: The lesser petrosal nerve passes through foramen ovale to reach otic ganglion in the infratemporal fossa. Correct answer: c) Foramen ovale.
Chapter: Neuroanatomy
Topic: Cranial Nerves
Subtopic: Accessory Nerve
Keyword Definitions:
Accessory Nerve: Cranial nerve XI, with spinal and cranial parts.
Cranial Part: Joins vagus nerve to supply palatal, pharyngeal, and laryngeal muscles.
Tensor Veli Palatini: Supplied by mandibular nerve, not accessory nerve.
Palatoglossus: Supplied by cranial part of accessory via vagus.
Palatopharyngeus: Receives motor supply from accessory via vagus.
Tensor Veli Tympani: Supplied by mandibular nerve branch.
Lead Question – 2012
Cranial part of accessory nerve supplies all palatal muscles, EXCEPT?
a) Palatoglossus
b) Palatopharyngeus
c) Tensor veli palatini
d) Tensor veli tympani
Explanation: The cranial part of the accessory nerve joins the vagus nerve to supply most palatal muscles except tensor veli palatini, which is supplied by the mandibular division of the trigeminal nerve. Correct answer: c) Tensor veli palatini.
Question 2. A patient presents with nasal regurgitation after surgery. The most likely injured muscle supplied by cranial accessory nerve is?
a) Palatoglossus
b) Tensor veli palatini
c) Palatopharyngeus
d) Stylopharyngeus
Explanation: Palatopharyngeus elevates the pharynx and closes the nasopharynx during swallowing. Injury leads to nasal regurgitation. Correct answer: c) Palatopharyngeus.
Question 3. Which palatal muscle prevents food from entering the nasopharynx?
a) Tensor veli palatini
b) Palatopharyngeus
c) Palatoglossus
d) Levator veli palatini
Explanation: Levator veli palatini elevates the soft palate to prevent food from entering the nasopharynx during swallowing. Correct answer: d) Levator veli palatini.
Question 4. Which nerve supplies the stylopharyngeus muscle?
a) Glossopharyngeal
b) Accessory
c) Vagus
d) Mandibular
Explanation: Stylopharyngeus is the only muscle supplied by glossopharyngeal nerve (CN IX). Correct answer: a) Glossopharyngeal.
Question 5. In lesion of cranial accessory nerve, which symptom is seen?
a) Hoarseness
b) Tongue deviation
c) Shoulder droop
d) Loss of gag reflex
Explanation: Lesion affects muscles of larynx and pharynx via vagus, leading to hoarseness and dysphagia. Correct answer: a) Hoarseness.
Question 6. A tumor compressing jugular foramen damages which nerves?
a) IX, X, XI
b) VII, IX, XI
c) IX, X, XII
d) X, XI, XII
Explanation: The jugular foramen transmits glossopharyngeal, vagus, and accessory nerves. Correct answer: a) IX, X, XI.
Question 7. A 45-year-old patient has palatal droop and uvula deviation to the right. The lesion is on?
a) Right accessory nerve
b) Left vagus nerve
c) Right glossopharyngeal nerve
d) Left hypoglossal nerve
Explanation: Uvula deviates to the opposite side of lesion due to vagus involvement. Correct answer: b) Left vagus nerve.
Question 8. Which palatal muscle is supplied by mandibular nerve?
a) Tensor veli palatini
b) Levator veli palatini
c) Palatoglossus
d) Palatopharyngeus
Explanation: Tensor veli palatini is the only palatal muscle supplied by mandibular nerve (V3). Correct answer: a) Tensor veli palatini.
Question 9. Injury to spinal accessory nerve leads to weakness of?
a) Sternocleidomastoid and trapezius
b) Masseter and temporalis
c) Levator scapulae and rhomboid
d) Palatoglossus and tensor veli palatini
Explanation: The spinal part of accessory nerve supplies sternocleidomastoid and trapezius. Injury causes shoulder droop and weak head rotation. Correct answer: a) Sternocleidomastoid and trapezius.
Question 10. Which nerve provides motor supply to intrinsic laryngeal muscles (except cricothyroid)?
a) External branch of superior laryngeal nerve
b) Recurrent laryngeal nerve
c) Glossopharyngeal nerve
d) Spinal accessory nerve
Explanation: Recurrent laryngeal nerve, branch of vagus, supplies all intrinsic laryngeal muscles except cricothyroid. Correct answer: b) Recurrent laryngeal nerve.
Question 11. A patient with vagus nerve lesion develops aspiration during swallowing. Which muscle is most affected?
a) Palatopharyngeus
b) Cricopharyngeus
c) Tensor veli palatini
d) Stylopharyngeus
Explanation: Cricopharyngeus (upper esophageal sphincter) controlled by vagus is impaired, leading to aspiration. Correct answer: b) Cricopharyngeus.