Practice Quiz - Upper GI Tract
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  1. The entry of bacteria through which space could lead to an infection in the mastoid air cells:
    Auditory (nasopharyngeal) tube
    Cochlea
    External acoustic meatus
    Internal acoustic meatus
    Sacculus
  2. A 45-year old woman with recurrent left middle ear infection (otitis media) complained of partial dryness of her mouth to her ENT surgeon. Taste sensation and hearing were normal. After a thorough clinical examination at the hospital, the doctor concluded that the infection must have spread to a component of the glossopharyngeal nerve (CN IX) that supplies the parotid gland. On which of the following walls of the middle ear is this nerve component located?
    Anterior
    Lateral
    Medial
    Posterior
    Roof
  3. An elderly patient with chronic otitis media (middle ear infection) might have all the following complications EXCEPT:
    Inabilty to chew food due to injury to the mandibular division of the trigeminal nerve (CN V)
    Loss of taste in the anterior part of the tongue due to injury to the chorda tympani nerve
    Mastoiditis
    Paralysis of facial muscles due an injury to the facial nerve (CN VII)
    Some degree of deafness due to damage to the ossicles
  4. A patient's MR reveals a tumor pressing against the otic ganglion, which is located in the:
    Pterygopalatine fossa
    Internal ear
    Infratemporal fossa
    Middle cranial fossa
    None of the above
  5. A patient complains of decreased taste sensation. An MR of the patient's skull reveals a small tumor within the temporal bone, pressing on the geniculate ganglion, which is the sensory ganglion of which nerve:
    Facial
    Glossopharyngeal
    Trigeminal
    Vagus
    Vestibulocochlear
  6. The soft palate is active in all of the following except:
    Breathing
    Chewing
    Coughing
    Swallowing
    Yawning
  7. Loss of sensation from the temporal region and loss of secretory function of the parotid gland would be caused by interruption of which nerve?
    Auriculotemporal
    Chorda tympani
    Deep temporal, posterior
    Facial
    Great auricular
  8. During a face lift operation on a 48-year-old woman, the plastic surgeon inadvertently cut the marginal mandibular branch of the facial nerve. Which of the following muscles would be paralyzed because of the injury?
    Buccinator
    Depressor anguli oris
    Levator anguli oris
    Levator labii superioris
    Stylohyoid
  9. As a result of a face lift operation, a 46-year-old woman noticed an asymmetry of the inferior lip and could not fully depress the angle of her mouth on the right side. Which of the following nerves was most likely damaged during the surgery?
    zygomatic (VII)
    buccal (VII)
    mental (V3)
    marginal mandibular (VII)
    infraorbital (V2)
  10. Due to multiple salivary calculi (stones) in the submandibular duct, the submandibular gland of a 45-year-old individual was surgically removed. What major artery directly related to the gland was of special concern to the surgeon?
    lingual
    superior thyroid
    facial
    ascending pharyngeal
    maxillary
  11. To study the compensatory response of selective suprahyoid muscles in elevating the hyoid bone, an experiment was designed in which the posterior belly of the digastric and stylohyoid muscles were paralyzed by drugs. The muscular branches of which of the following nerves must be chemically interrupted to produce paralysis in both muscles?
    inferior alveolar
    facial
    hypoglossal
    glossopharyngeal
    lingual
  12. Which nerve provides motor innervation to the buccinator muscle?
    Auriculotemporal nerve
    Buccal branches of VII
    Buccal nerve
    Mandibular division of V
    Marginal mandibular nerve
  13. Which nerve provides cutaneous innervation to the skin of the angle of the mandible?
    Auriculotemporal nerve
    Lesser petrosal nerve
    Buccal branches of VII
    Marginal mandibular nerve
    Great auricular nerve
  14. Which nerve carries postganglionic parasympathetic fibers to the parotid gland?
    Auriculotemporal nerve
    Lesser petrosal nerve
    Glossopharyngeal nerve
    Great auricular nerve
    Marginal mandibular nerve
  15. A patient is unable to wink; what muscle is affected?
    frontalis
    levator palpebrae superioris
    orbicularis oculi
    superior tarsal
    zygomaticus major
  16. What structure lies deepest in the parotid gland?
    External carotid artery
    External jugular vein
    Facial artery
    Facial nerve
    Retromandibular vein
  17. A deep laceration of the face in the middle of the parotid gland could affect the:
    External jugular vein
    Facial nerve
    Glossopharyngeal nerve
    Hypoglossal nerve
    Lingual artery
  18. Pain elicited from an infected facial wound is primarily conveyed by what nerve?
    Facial
    Great auricular
    Hypoglossal
    Transverse cervical
    Trigeminal
  19. Inability to close the lips relates to the action of which muscle?
    Anterior belly of the digastric
    Mylohyoid
    Orbicularis oris
    Platysma
    Zygomaticus major
  20. Which muscle will not be affected when the mandibular division of the trigeminal nerve (V3) is anesthetized?
    Anterior belly of digastric
    Buccinator
    Medial pterygoid
    Mylohyoid
    Temporalis
  21. A 38-year-old female patient complained of parotid pain that increased while eating. Intraoral examination detected some pus oozing from the parotid duct opening. What was the most likely anatomical reference that the physician considered to locate the parotid duct opening?
    Mucosa of the sublingual caruncle behind the central incisor teeth
    Mucosa of the cheek across the 2nd upper (maxillary) molar tooth
    Mucosa of the floor of the mouth along the sublingual fold
    Mucosa of the cheek across the 2nd lower (mandibular) molar tooth
  22. While recovering from a right facial paralysis, a 36-year-old female patient complained that food accumulated between the teeth and the cheek mucosa when chewing. The deficiency of which muscle was most likely the cause of the chewing problem?
    Zygomaticus major
    Orbicularis oris
    Buccinator
    Levator labii superioris
  23. The parotid space contains all EXCEPT:
    External carotid artery
    Facial nerve
    Intraparotid lymph nodes
    Medial pterygoid muscle
    Retromandibular vein
  24. As a result of meningitis, a patient develops Bell's palsy. One of the symptoms was hyperacusis. What nerve was involved?
    Facial
    Glossopharyngeal
    Oculomotor
    Trigeminal
    Vagus
  25. Frey's Syndrome is marked by profuse sweating over one cheek, temple, and surrounding areas of the face, precipitated by eating. The condition may be idiopathic, but often follows parotid surgery. The condition is attributable to abberant reinnervation, the redirection of autonomic fibers normally going to salivary glands being redirected to sweat glands. What is the source of the nerve fibers involved?
    Facial
    Glossopharyngeal
    Oculomotor
    Trigeminal
    Vagus
  26. The facial muscle most responsible for moving the lips both upward and laterally to produce a smile is:
    Buccinator
    Levator anguli oris
    Levator labii superioris
    Platysma
    Zygomaticus major
  27. To drain an abscess (a closed collection of pus) affecting the cheek area, an emergency room physician used local anesthesia for the surgery. Which of the following nerves must be anesthetized because it carries pain sensation from the cheek area?
    buccal (V3)
    buccal (VII)
    inferior alveolar
    lingual
    mental
  28. A patient who experienced bilateral anterior dislocation of the jaw (temporomandibular joints) could not swallow or talk since the mouth was held open. What is the position of the condyles of the mandible as a result of the dislocation?
    against the external acoustic meatus
    against the anterior slope of the articular eminence
    against the posterior slope of the articular eminence
    in the mandibular fossa
    in the pterygoid fossa
  29. In reducing an ankylosis of the TMJ, a surgeon provoked an intense hemorrhage by lacerating the artery coursing transversely just medial to the neck of the condyle. Which artery was involved in the accident?
    Buccal
    External carotid
    Maxillary
    Middle meningeal
    Superficial temporal
  30. The muscle which separates the submandibular triangle from the paralingual space is the:
    Digastric, posterior belly
    Hyoglossus
    Mylohyoid
    Stylohyoid
    Styloglossus
  31. The predominant muscle most associated with retraction of the mandible is the:
    lateral pterygoid
    masseter
    medial pterygoid
    temporalis
    mylohyoid
  32. At the temporomandibular joint (TMJ), hinge movements occur between the:
    condyle and articular eminence
    articular disc and articular eminence
    condyle and articular disc
    articular disc and articular cavity
    condyle and articular cavity
  33. A 38-year-old patient complained of acute dental pain. The attending dentist found penetrating dental caries (dental decay) affecting one of the mandibular molar teeth. Which nerve would the dentist need to anesthetize to work on that tooth?
    Lingual
    Inferior alveolar
    Buccal
    Mental
    Mylohyoid
  34. Inability to protrude the mandible indicates a dysfunction of which muscle?
    Anterior belly of digastric
    Buccinator
    Lateral pterygoid
    Mylohyoid
    Temporalis
  35. Damage to the facial nerve near the stylomastoid foramen would likely cause each of the following motor deficits EXCEPT:
    Paralysis of the buccinator muscle
    Inability to whistle
    Paralysis of the muscles that elevate the mandible
    Inability to close the lips
  36. The lesser petrosal nerve carries preganglionic parasympathetic fibers to the:
    Geniculate ganglion
    Otic ganglion
    Submandibular ganglion
    Ciliary ganglion
  37. Which of the following suprahyoid muscles would be paralyzed if the inferior alveolar nerve were severed at its origin?
    Geniohyoid m.
    Hyoglossus m.
    Mylohyoid m.
    Stylohyoid m.
  38. Which nerve is endangered during surgical removal of an impacted third mandibular molar tooth?
    Hypoglossal n.
    Glossopharyngeal n.
    Inferior alveolar n.
    Lingual n.
  39. After the mandibular condyle is moved forward onto the articular eminence (e.g., by opening the mouth widely), what muscle can then retract the mandible?
    Superficial head of masseter m.
    Deep head of masseter m.
    Posterior part of temporalis m.
    Anterior part of temporalis m.
  40. Two nerves usually emerge from between the two heads of the lateral pterygoid muscle: the anterior deep temporal nerve and the:
    Masseteric n.
    Buccal n.
    Lingual n.
    Inferior alveolar n.
  41. The chorda tympani enters the infratemporal fossa after it exits the:
    Stylomastoid foramen
    Foramen spinosum
    Foramen lacerum
    Petrotympanic fissure
  42. Paralysis of which of the following muscles would impede retraction of the mandible?
    Buccinator
    Lateral pterygoid, lower portion
    Lateral pterygoid, upper (sphenomeniscus) portion
    Medial pterygoid
    Temporalis
  43. A cranial fracture through the foramen ovale that compresses the enclosed nerve, will have an effect on all muscles EXCEPT :
    Tensor tympani
    Masseter
    Buccinator
    Mylohyoid
    Temporalis
  44. Which muscle is also known as the sphenomeniscus?
    Inferior head of the lateral pterygoid
    Masseter
    Medial pterygoid
    Superior head of the lateral pterygoid
    Temporalis
  45. Forward movement of the condyle of the mandible during wide opening of the jaws is accomplished mainly by the:
    anterior part of temporalis muscle
    lateral pterygoid muscle
    masseter muscle
    medial pterygoid muscle
    posterior part of the temporalis muscle
  46. To drill a mandibular tooth without causing undue pain, a dentist has injected an anesthetic into the space located between the medial pterygoid muscle and the mandible near the lingula. Given the nerves passing through the immediate vicinity of the injection site, where would one expect anesthesia in addition to the mandibular teeth?
    back of tongue
    external ear
    maxillary incisor teeth
    skin of chin
    upper lip
  47. The middle meningeal artery:
    enters the skull through the foramen ovale
    passes through a split in the trunk of the mandibular nerve (V3)
    is typically a branch of the second part of the maxillary artery
    supplies blood to the temporal lobe of the brain
    usually arises deep to the neck of the mandible
  48. The surgical removal of a metastatic tumor in the infratemporal fossa caused an intense hemorrhage. The surgeon clamped the main source of arterial supply to the area, which is the:
    Internal carotid
    Lingual
    Maxillary
    Posterior auricular
    Superficial temporal
  49. In acute inflammation (arthritis) of the TMJ, the muscle most likely to be affected by the inflammatory process is the:
    Temporal
    Medial pterygoid
    Masseter
    Lateral pterygoid
  50. In explaining the pain caused by the drilling of a mandibular molar tooth crown to a freshman medical student, a dentist identified the nerve conducting the pain sensations as the:
    Lingual
    Mylohyoid
    Inferior alveolar
    Buccal
  51. The temporomandibular joint is characterized by all EXCEPT:
    A capsule strengthened by ligaments on its lateral side only
    A completely flat surface for its gliding action
    An articular disc
    Extracapsular ligaments
    Two joint cavities of different shapes
  52. In dislocation of the jaw, displacement of the articular disc beyond the articular tubercle of the temporomandibular joint results from excessive contraction of which muscle?
    Buccinator
    Lateral pterygoid
    Medial pterygoid
    Masseter
    Temporalis
  53. Sympathetic fibers reach the tongue by way of the:
    lingual nerve
    maxillary artery
    hypoglossal nerve
    lingual artery
    glossopharyngeal nerve
  54. After a radiograph revealed a sialolith (stone) in a patient's right submandibular duct, the surgeon exposed the duct via an intraoral approach. In this approach, what tissues or structures must be cut through?
    Mucous membrane only
    Mucous membrane and genioglossus muscle
    Mucous membrane and mylohyoid muscle
    Mucous membrane and hyoglossus muscle
  55. Damage of the lingual nerve before it is joined by the chorda tympani in the infratemporal fossa would cause loss of:
    general sensation to the anterior two thirds of the tongue
    general sensation to the posterior one third of the tongue
    secretion of the submandibular gland
    taste sensation from the anterior two thirds of the tongue
    taste sensation from the posterior one third of the tongue
  56. The teeth and gums separate the oral cavity proper from the:
    Nasal cavity
    Oral vestibule
    Oropharynx
    Paralingual space
    Submandibular space
    Description for the following questions: Examination of a patient with an ulcerative carcinoma of the posterior third of the tongue revealed bleeding from the lesion and difficulty swallowing (dysphagia).
  57. The bleeding was seen to be arterial; which of the following arteries was involved?
    Deep lingual
    Dorsal lingual
    Facial
    Sublingual
    Tonsillar
  58. The difficulty in swallowing was due to involvement of which muscle that elevates the tongue?
    Genioglossus
    Hyoglossus
    Styloglossus
    Stylohyoid
    Stylopharyngeus
  59. Cutting of the hypoglossal nerve in the hypoglossal canal would not interrupt the nerve supply to the:
    Hyoglossus muscle
    Genioglossus muscle
    Palatoglossus muscle
    Styloglossus muscle
  60. The contents of the paralingual space do NOT include the:
    Hypoglossal nerve
    Lingual artery
    Lingual nerve
    Submandibular gland
    Sublingual gland
  61. A patient is unable to taste a piece of sugar placed on the anterior part of the tongue. Which cranial nerve is most likely to have a lesion?
    Facial nerve
    Glossopharyngeal nerve
    Hypoglossal nerve
    Trigeminal nerve
    Vagus nerve
  62. The chorda tympani contains which component before it joins the lingual nerve?
    Preganglionic sympathetics
    Postganglionic sympathetics
    Preganglionic parasympathetics
    Postganglionic parasympathetics
    Taste fibers to the posterior third of the tongue
  63. The cell bodies of the taste fibers from the anterior two-thirds of the tongue are located in the:
    Geniculate ganglion
    Otic ganglion
    Pterygopalatine ganglion
    Submandibular ganglion
    Trigeminal ganglion
  64. Which of the following structures is located in the vestibule of the oral cavity?
    Tongue
    Opening of the parotid duct
    Opening of the submandibular duct
    Sublingual fold
    Uvula
  65. When one presses the tongue tip against the anterior (incisor) teeth, which of the following muscles must contract?
    Styloglossus
    Hyoglossus
    Genioglossus
    Superior longitudinal
    Verticalis
  66. The muscle responsible for raising the floor of the mouth in the early stages of swallowing is the:
    genioglossus
    geniohyoid
    hyoglossus
    mylohyoid
    palatoglossus
  67. The cell bodies of the postganglionic parasympathetic neurons innervating the sublingual gland are found in which of the following ganglia?
    ciliary
    otic
    submandibular
    superior cervical
    trigeminal
  68. A 46-year-old female patient comes to the emergency department complaining of pain in the area just below her mandible on the right side of her face. She says that the pain is particularly severe when she eats. The area of the submandibular gland is tender and swollen, as is the area in the floor of her mouth lateral to the tongue. You suspect a stone in the submandibular duct, and a plain film radiograph shows a density in that region consistent with a stone. In order to remove the stone, the duct must be incised in the floor of the mouth. What nerve, that loops around the duct, is in danger in such an incision?
    Chorda Tympani
    Glossopharyngeal
    Hypoglossal
    Internal branch of the superior laryngeal
    Lingual
  69. In accessing the submandibular gland in the submandibular triangle, what vessel coursing through the gland and triangle would need to be protected?
    External jugular vein
    Facial artery
    Maxillary artery
    Retromandibular vein
    Superior thyroid artery
  70. All of the following may be found in the paralingual space EXCEPT:
    Hypoglossal nerve
    Lingual nerve
    Sublingual gland
    Submandibular gland duct
    Superficial lobe of the submandibular gland
  71. 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
  72. The constrictor muscles of the pharynx receive their motor nerve supply from the:
    Glossopharyngeal nerve
    Hypoglossal nerve
    Spinal accessory nerve
    Sympathetic trunk
    Vagus nerve
  73. 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
  74. 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
  75. 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
  76. The carotid body is innervated by a branch of the:
    Glossopharyngeal nerve
    Hypoglossal nerve
    Spinal accessory nerve
    Sympathetic trunk
    Vagus nerve