Practice Quiz - Larynx and Neck
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  1. A person receives a shallow knife wound just behind the sternocleidomastoid muscle and about 1 1/2 inches above the clavicle. There is an immediate numbness of the skin below the wound and over the acromion and clavicle. The nerve most likely severed was the
    greater auricular
    lesser occipital
    supraclavicular
    suprascapular
    transverse cervical
  2. Which muscle is innervated by a branch of the ansa cervicalis?
    Sternocleidomastoid
    Platysma
    Sternohyoid
    Trapezius
  3. The layer of encircling cervical fascia that splits to enclose sternocleidomastoid and trapezius muscles is the:
    Superficial fascia
    Superficial layer of deep fascia
    Infrahyoid fascia
    Prevertebral fascia
    Visceral fascia
  4. Which of the following is a dorsal ramus of a spinal nerve?
    Supraclavicular n.
    Transverse cervical n.
    Great auricular n.
    Greater occipital n.
    Lesser occipital n.
  5. Which of the following is true of the inferior thyroid arteries?
    They arise from the external carotid arteries
    They cross over the superior cervical sympathetic ganglion
    They supply most of the anterior surface of the thyroid gland
    They often supply all four parathyroid glands
  6. A 20 year old man was brought into the emergency room with a stab wound in the upper part of the neck. Although there was no major damage done, he lost sensation from the skin over the angle of the jaw. Which nerve has been cut?
    Supraclavicular n.
    Transverse cervical n.
    Great auricular n.
    Greater occipital n.
    Lesser occipital n.
  7. The triangle in which the superior branch of the ansa cervicalis separates from the hypoglossal nerve is the:
    Carotid
    Muscular
    Subclavian
    Submental
    Occipital
  8. Exploration of the tracheoesophageal groove at the level of the thyroid gland would reveal what important structure bilaterally?
    Cervical sympathetic trunk
    Phrenic nerve
    Pyramidal lobe
    Recurrent laryngeal nerve
    Superior thyroid artery
  9. A 35 year old woman was diagnosed with an adenoma of the thyroid gland. This required excision of the lower pole (left lobe) of the gland and ligation of the artery supplying that region. Which of the following nerves accompanying the artery is most likely to be damaged if the surgeon is not careful?
    External branch of the superior laryngeal
    Internal branch of the superior laryngeal
    Recurrent laryngeal
    Vagus proper
    Sympathetic trunk
  10. One of the motor components of the cervical plexus, the ansa cervicalis, innervates all of the following muscles except the:
    Omohyoid
    Sternohyoid
    Sternothyroid
    Stylohyoid
    Thyrohyoid
  11. A man has metastatic carcinoma and enlarged deep cervical lymph nodes. One of his symptoms is a hoarse voice, barely heard above a whisper. Subsequently he succumbs to the disease and at autopsy it is found that one of the enlarged nodes has put pressure on a nerve in the tracheoesophageal groove. Presumably this was the reason for the hoarse voice. What nerve was involved?
    External branch of the superior laryngeal nerve
    Internal branch of the superior laryngeal nerve
    Nerve to the cricothyroid muscle
    Pharyngeal branch of the glossopharyngeal nerve
    Recurrent laryngeal branch of vagus
  12. You are called on to do a venous catheterization to measure central venous pressure in the heart. Which muscle of the neck would provide the best area of approach to the internal jugular vein?
    Anterior scalene
    Digastric
    Omohyoid
    Sternocleidomastoid
    Sternohyoid
  13. A patient is brought into the Emergency Room in respiratory distress. It is quickly decided to create an emergency airway to restore respiration. At what level could you rapidly create an airway below the vocal cords with a minimum danger of hemorrhage?
    Just above the jugular notch
    Just above the thyroid cartilage
    Just below the cricoid cartilage
    Just below the thyroid cartilage
    Through the 3rd tracheal ring
  14. A 47-year-old woman is diagnosed as having a thyroid tumor. Surgery to remove the cancerous growth is undertaken. In which triangle of the neck will the surgeon make an incision to gain access to the gland?
    Carotid
    Muscular
    Subclavian
    Submandibular
    Submental
  15. A 50-year-old woman is brought to the operating room for a biopsy of a suspicious looking nevus (mole) which is found along the anterior border of her sternocleidomastoid muscle at about its midlength. What nerve must be locally anesthetized for the operation to proceed without pain?
    Ansa cervicalis
    External branch of the superior laryngeal
    Great auricular
    Supraclavicular
    Transverse cervical
  16. Following surgery on the upper pole of the right lobe of the thyroid gland, a patient complains of hoarseness and weakness of voice. What nerve may have been injured?
    Ansa cervicalis
    External branch of the superior laryngeal
    Inferior laryngeal
    Internal branch of the superior laryngeal
    Recurrent laryngeal
  17. These structures are all located in the superficial fascia of the neck EXCEPT
    External jugular vein
    Platysma muscle
    Cervical branch of the facial nerve
    Omohyoid muscle
    Transverse cervical nerve
  18. The superior belly of the omohyoid forms the anterior border of which cervical triangle?
    Carotid
    Muscular
    Omoclavicular
    Posterior
    Submandibular
  19. The cervical plexus innervates all of the following structures EXCEPT:
    Diaphragm
    Omohyoid muscle
    Platysma
    Skin over thyroid cartilage
    Skin over clavicle
  20. An emergency room patient presented with considerable bleeding from a shallow stab wound in the omoclavicular triangle. Which vessel was most likely cut?
    Axillary vein
    Common carotid artery
    External jugular vein
    Inferior thyroid vein
    Superior thyroid artery
  21. Which structure or area receives NO nerve fibers from the cervical plexus?
    Diaphragm
    Skin over the angle of the mandible
    Skin over the external occipital protuberance
    Thyrohyoid muscle
  22. A six-year-old child, whose medical history includes a rather difficult birth, has a permanently tilted head posture, with the right ear near the right shoulder and the face turned upward and to the left. Which of the following muscles was very likely damaged during birth?
    Anterior scalene
    Omohyoid
    Sternocleidomastoid
    Trapezius
    Platysma
  23. Any irritation of the diaphragm (e.g. infection, tumor) may create referred pain that seems (to the patient) to originate in the area atop the shoulder. This is due to the fact that the phrenic nerve shares spinal segments with what cutaneous nerve in the shoulder region?
    Dorsal scapular
    Lesser occipital nerve
    Long thoracic nerve
    Supraclavicular nerve
    Suprascapular nerve
  24. Which of the following statements about the cervical plexus is true?
    It comprises spinal segments C1-C3
    It consists solely of cutaneous nerves
    It consists solely of ventral rami of spinal nerves
    It supplies motor innervation to platysma
  25. A muscular patient who regularly lifts weights presents with pain and weakness in his right upper limb that has been slowly developing over time. His limb is cool and there is an obvious vascular insufficiency in his upper extremity. Subsequent tests show that a large vessel passing between the anterior and middle scalene muscles is being occluded by hypertrophy (enlargement) of the muscles due to the excercise. The artery involved is the:
    axillary
    brachial
    brachiocephalic
    subclavian
    suprascapular
  26. In repairing a damaged right subclavian artery, the surgeon notices and protects a large nerve passing around to the posterior surface of the artery. This nerve, which does not encircle the subclavian on the left side, is the:
    Phrenic
    Vagus
    Recurrent laryngeal
    Sympathetic trunk
    Ansa cervicalis
  27. A stab wound just above the left clavicle, lateral to the sternocleidomastoid muscle, may be life-threatening because of the possibility of injury to the:
    Brachial plexus
    Internal jugular vein
    Axillary artery
    Subclavian artery
    Thoracic duct
  28. A 27-year-old man who is a professional weight lifter comes to his physician complaining of recent weakness in his left arm and frequent tingling in his hand and fingers during exercise sessions which subsides with rest. He is diagnosed as having vasuclar insufficiency due to scalenus anticus syndrome and as a remedy it is decided to transect the anterior scalene muscle where it inserts on the first rib. During surgery, which structure in contact with the anterior surface of the muscle must the surgeon be careful of sparing?
    Inferior trunk of the brachial plexus
    Long thoracic nerve
    Phrenic nerve
    Sympathetic trunk
    Vagus nerve
  29. A 60-year-old man with a previous history of right carotid endarterectomy, comes to his physician complaining of light-headedness and dizziness whenever he uses his right hand vigorously. He is diagnosed as having subclavian steal syndrome due to an atherosclerotic plaque at the point where his subclavian artery branches from the brachiocephalic trunk. The cerebral insufficiency is the result of blood being stolen from which artery?
    External carotid
    Internal carotid
    Middle cerebral
    Thyrocervical trunk
    Vertebral
  30. A first year resident attempts to insert a central venous catheter into the heart by a subclavicular approach to the subclavian vein. Following the attempt, it is noted that the patient has difficulty breathing. What nervous structure lying immediately deep to the subclavian vein, as it crosses the anterior scalene muscle, may have been injured?
    External branch of the superior laryngeal nerve
    Phrenic nerve
    Recurrent laryngeal nerve
    Sympathetic trunk
    Vagus nerve
  31. Which statement is true of the internal jugular vein?
    It drains all of the thyroid gland on that side of the body
    It drains into the external jugular vein
    It is accompanied by the deep cervical chain of lymph nodes
    It lies deep to the prevertebral fascia
    It passes superficial to the sternocleidomastoid muscle
  32. Which structure lies immediately anterior to the right anterior scalene muscle at its costal attachment?
    Subclavian artery
    Subclavian vein
    Thoracic duct
    Thyrocervical trunk
    Vagus nerve
  33. A person develops a primary tumor of the thyroid gland and, among other symptoms, drooping of the eyelid and constriction of the pupil on the right side of the eye are noted. What nerve fibers have been interrupted by the tumor?

    postganglionic parasympathetic
    postganglionic sympathetic
    preganglionic parasympathetic
    the carotid nerve
    the cervical sympathetic trunk
  34. An abscess was surgically removed from the middle of the posterior triangle on the right side. During recovery the patient noticed that her shoulder drooped and she could no longer raise her right hand above her head to brush her hair. Which nerve has been cut?
    Accessory (XI)
    Ansa cervicalis
    Facial (VII)
    Hypoglossal (XII)
    Suprascapular
  35. A surgeon doing a deep cervical lymph node dissection may encounter these structures upon the anterior surface of the anterior scalene muscle EXCEPT:
    Phrenic nerve
    Subclavian vein
    Middle trunk of the brachial plexus
    Transverse cervical artery
    Cervical part of the thoracic duct
  36. The middle cervical sympathetic ganglion, recurrent laryngeal nerve, and parathyroid glands are all closely related with which blood vessel?
    Inferior thyroid artery
    Inferior thyroid vein
    Superior thyroid artery
    Superior thyroid vein
  37. During surgical procedures of the neck, structures within the carotid sheath can be retracted (pulled aside) as a unit. Which of the following structures would remain in place when the carotid sheath is retracted?
    common carotid artery
    cervical sympathetic trunk
    internal jugular vein
    internal carotid artery
    vagus nerve
  38. Which of the following nerves is derived from the dorsal primary rami of spinal nerves?
    great auricular
    greater occipital
    lesser occipital
    phrenic
    supraclavicular
  39. Which of the following hyoid muscles is an important landmark in both the anterior and posterior triangles of the neck?
    geniohyoid
    mylohyoid
    omohyoid
    sternohyoid
    stylohyoid
  40. Following thyroid surgery, it was noted that a patient frequently aspirated fluid into her lungs. Upon examination it was determined that the area of the piriform recess above the vocal fold of the larynx was numb. What nerve may have been injured?
    External branch of the superior laryngeal
    Hypoglossal
    Internal branch of the superior laryngeal
    Lingual
    Recurrent laryngeal
  41. The laryngeal muscle most responsible for stretching (elongating) the vocal ligament is the :
    Posterior cricoarytenoid
    Lateral cricoarytenoid
    Thyroarytenoid
    Arytenoid
    Cricothyroid
  42. The muscle most responsible for the abduction of the vocal folds is the :
    Arytenoid
    Cricothyroid
    Lateral cricoarytenoid
    Posterior cricoarytenoid
    Thyroarytenoid
  43. The nerve that innervates all but one muscle of larynx is the:
    Glossopharyngeal nerve, pharyngeal branch
    Inferior laryngeal nerve
    Superior laryngeal nerve, external branch
    Superior laryngeal nerve, internal branch
    Thyrohyoid nerve
  44. The vocalis muscle is most responsible for the fine control of phonation because of its attachment into the:
    Arytenoid cartilage
    Cricoid cartilage
    Thyroid cartilage
    Vestibular ligament
    Vocal ligament
  45. The constrictor muscles of the pharynx receive their motor nerve supply from the:
    Glossopharyngeal nerve
    Hypoglossal nerve
    Spinal accessory nerve
    Sympathetic trunk
    Vagus nerve
  46. Twenty-four hours following a partial thyroidectomy where the inferior thyroid artery was also ligated (tied off), the patient now spoke with a hoarse voice (whisper), and had difficulty in breathing. Which nerve was injured?

    Internal branch of superior laryngeal
    Ansa cervicalis
    Ansa subclavia
    Recurrent laryngeal
    External branch of superior laryngeal
  47. In performing a thyroidectomy, caution should be exercised when ligating (tying) the inferior thyroid artery, as it lies in a very close relationship to which nerve?
    ansa cervicalis
    hypoglossal
    phrenic
    recurrent laryngeal
    vagus
  48. A 60-year-old man has occasional blackouts and light-headedness. Studies reveal atherosclerotic plaques within the common carotid arteries and the bifurcation of the vessels. A carotid endartectomy is undertaken. Which nerve bundle running vertically within the carotid sheath must the surgeon be careful not to injure?
    Accessory
    Cervical sympathetic trunk
    Glossopharyngeal
    Hypoglossal
    Vagus
  49. A 55-year-old woman has difficulty swallowing and frequently aspirates fluids while drinking. She is diagnosed as having a skull base tumor occupying the space behind the jugular foramen. Involvement of which structure is responsible for the findings?
    Ansa cervicalis
    Cervical sympathetic trunk
    Accessory nerve
    Hypoglossal nerve
    Vagus
  50. While doing a postoperative physical on a patient who has undergone carotid endarterectomy on the right side, it was noted that the tongue deviated toward the right when the patient was asked to point the tongue outward. What nerve crossing the carotid artery must have been injured?
    Glossopharyngeal
    Hypoglossal
    Inferior alveolar
    Lingual
    Vagus
  51. Any manipulation of the superior thyroid artery must be undertaken with care not to damage its small companion nerve, the:
    Cervical sympathetic trunk
    External branch of the superior laryngeal
    Inferior root of the ansa cervicalis
    Internal branch of the superior laryngeal
    Recurrent laryngeal
  52. The carotid body is innervated by a branch of the:
    Glossopharyngeal nerve
    Hypoglossal nerve
    Spinal accessory nerve
    Sympathetic trunk
    Vagus nerve