Zill Review

Question 1

Anterior Cleft Palate

Answer 1

Same as cleft lip. Do not fuse medial nasal process and maxillary process

Question 2

Posterior Cleft Palate

Answer 2

Failure to fuse secondary palate (maxillary processes of each side)

Question 3

Complications of tonsillectomy

Answer 3

1) post-operative bleeding of tonsillar branch of facial artery
2) damage to CN IX (Glossopharyngeal)

Question 4

True/false: Veins of the spinal cord have no valves

Answer 4

TRUE

Question 5

Example of cancer which can metastasize to vertebral column

Answer 5

Carcinoma of prostate (in the pelvis)

Question 6

Symptom of maxillary sinus infection

Answer 6

toothache

Question 7

How is pressure in the middle ear equalized

Answer 7

Tensor and Levator Palati transiently open auditory tube when swallowing

Question 8

Torticollis

Answer 8

contracture of sternocleidomastoid (congenital or acquired); face to OPPOSITE side

Question 9

Structure forming a lingual thyroid

Answer 9

Thyroglossal ducts remnants

Question 10

Innervation of muscles of the tongue

Answer 10

Hypoglossal Nerve (CN XII)

Question 11

Internal and External Jugular Veins: which descends in the carotid sheath and which descends on the outer surface of sternocleidomastoid?

Answer 11

Internal Jugular Vein is in the carotid sheath. External Jugular Vein descends on the outer surface of sternocleidomastoid

Question 12

Lateral Cricoarytenoid muscles

Answer 12

close rima glottidis

Question 13

Upper motor neuron lesion of hypoglossal nerve

Answer 13

Protruded tongue deviates AWAY from side of lesion to cortex, etc.. (control only contralateral). This is all due to unopposed action of the genioglossus muscle

Question 14

Action of cricothyroid muscle

Answer 14

Stretches vocal ligament, increasing pitch

Question 15

Anaphylactic shock

Answer 15

Acute allergic reaction. Swelling of vestibular folds; can constrict airway and lead to suffocation.

mucosa is tightly attached to vocal folds thats why it happens in the false not true vocal folds

Question 16

Symptoms of parotid tumors and mumps

Answer 16

1) Ear (outer) ache due to compression of Auriculotemporal Nerve (V3)
2) Facial Paralysis – Compress VII

Question 17

Innervation of mucous glands of nose and palate

Answer 17

Parasympathetics from CN VII

Question 18

Sensory innervation to Post 1/3 of tongue

Answer 18

CN IX

Question 19

Ludwig’s Angina

Answer 19

Infection of floor of mouth (submandibular space), often due to spread from abscessed mandibular tooth. Infection may obstruct airway and push up tongue

Question 20

Plaque at carotid bifurcation

Answer 20

Can give rise to emboli in internal carotid artery and cause cerebrovascular occlusion STROKE

Question 21

Sensory innervation of the dura

Answer 21

• V1, V2, V3
• CN X (Vagus)
• Sensory branches of C1/C2

Question 22

Highly anastomosed artery leading into nasal cavity

Answer 22

Sphenopalatine Artery (from maxillary artery)

Question 23

Sensory and branchiomotor innervation to all muscles of larynx except cricothyroid muscle

Answer 23

Recurrent Laryngeal Nerve

Question 24

Action of tensor palati

Answer 24

tenses soft palate

Question 25

rima glottidis

Answer 25

opening between the true vocal cords and the arytenoid cartilages of the larynx

Question 26

"Popcorn 1"; First pharyngeal structure causing difficulty swallowing

Answer 26

Valleculae (in the oropharynx)

Question 27

Constrictor muscle continuous anteriorly with buccinator

Answer 27

superior constrictor

Question 28

Symptoms of nerve damage/tumor at stylomastoid foramen or in parotid gland

Answer 28

Facial (VII) paralysis only (as opposed to Neurinoma which damages VIII as well)

Question 29

Blood supply to palatine tonsil

Answer 29

Tonsillar branch of facial artery

Question 30

Inlet into the larynx found above the false vocal folds

Answer 30

Vestibule

Question 31

Sensory innervation of nasal cavity

Answer 31

V1 and V2

Question 32

Posterior Cricoarytenoid muscles

Answer 32

open rima glottidis

Question 33

Symptoms of Obstruction of Radicular Artery (of Adamklewicz)

Answer 33

1) paraplegia (corticospinal tracts, bilateral voluntaryparalysis of legs and lower body) 2) bilateral loss of pain and temperature sense (spinothalamic tract) 3) loss of sphincter control 4) sparing of vibration and position sense (dorsal columns; sensory)

Question 34

Contents of the carotid sheath

Answer 34

1) common and internal carotid arteries 2) internal jugular vein 3) CN X (Vagus)

Question 35

Lower motor neuron lesion of hypoglossal nerve

Answer 35

Protruded tongue deviates TOWARD side of lesion. Unopposed action of the genioglossus muscle of one side.

Question 36

Can occur during clamping for heart surgery or by a dissecting aortic aneurysm; causes infarction (tissue death in spinal cord) similar to an anterior spinal artery syndrome

Answer 36

Obstruction of Radicular Artery (of Adamklewicz)

Question 37

Action of thyroarytenoid muscle

Answer 37

Relax vocal ligament, decreasing pitch

Question 38

Sensory innervation of floor of mouth

Answer 38

V3

Question 39

Clinical intervention in anaphylactic shock

Answer 39

Insert tube into cricothyroid membrane (in between thyroid and cricoid cartilages) to allow air in. This results in less bleeding that tracheotomy

Question 40

Innervation of tensor palati

Answer 40

CN V

Question 41

What are surgeons cautious about damaging in (neck) posterior triangle surgery?

Answer 41

Brachial plexus and the phrenic nerve

Question 42

Damage can occur to this nerve in thyroid surgery, paralyzing all muscles on one side except cricothyroid; permanent hoarse voice

Answer 42

Recurrent Laryngeal Nerve

Question 43

Why can tongue cancer spread to opposite side easily?

Answer 43

Lymph vessels of tongue cross the midline; lesion may spread to the opposite side

Question 44

Suboccipital muscles and actions

Answer 44

1) Rectus Capitis Posterior Minor (Extend head) 2) Rectus Capitis Posterior Major (Extend/Rotate) 3) Obliquus Capitis Superior (Extend) 4) Obliquus Capitis Inferior (Rotate; has stretch receptors to sense neck rotation)

Question 45

Three Pharynx constrictor muscles

Answer 45

Superior, Middle, and Inferior Constrictor

Question 46

Visceral sensory endings of this nerve monitor blood pressure and chemoreception. Damage to it can lead to cardiac-pulmonary dysfunction

Answer 46

CN IX

Question 47

Sensory innervation to Ant 2/3 of tongue

Answer 47

V3 (lingual nerve; somatic sensory touch) and CN VII (chorda tympani - taste)

Question 48

Area between true and false vocal folds; Lateral extension is Laryngeal Sinus

Answer 48

Ventricle

Question 49

Damage to lingual nerve in floor of mouth

Answer 49

Lose taste (CN VII) and Touch (V) to anterior 2/3 of tongue

Question 50

angina

Answer 50

A condition with intense pain

Question 51

Two folds overlying vestibular ligaments (superior to inferior)

Answer 51

Vestibular (false vocal) and Vocal (true vocal) folds

Question 52

Significance of veins of spinal cord having no valves

Answer 52

Metastasis to Vertebral Column Disease processes can spread to spinal cord and vertebra by intervertebral veins.

Question 53

Motor innervation to muscles of palate

Answer 53

Vagus (CN X) for all muscles of the palate except Trigeminal (CN V) for tensor palati

Question 54

The Superior Laryngeal Nerve divides into Internal/External Laryngeal Nerves. What do they do?

Answer 54

Internal Laryngeal Nerve - sensory | External Laryngeal Nerve - branchiomotor to Cricothyroid muscle

Question 55

Sensory supply to Maxillary sinus and the teeth

Answer 55

Anterior and Posterior Superior Alveolar Nerves (from V2)

Question 56

Sensory innervation of palate

Answer 56

V2

Question 57

Origin and Insertion of Tensor Palati

Answer 57

Origin: Auditory Tube Insertion: Palatine Aponeurosis

Question 58

Steps of swallowing

Answer 58

Voluntary: 1) Form bolus [Palate down by Palatoglossus] 2) Push bolus back [contract mylohyoid and styloglossus] Involuntary: 3) Elevate soft palate [contract Tensor Palati, Levator Palati, and Stylopharyngeus] 4) Down tube [contract pharyngeal constrictors; pull larynx forward with hyoid muscles]

Question 59

Artery arising from carotid siphon

Answer 59

opthalmic artery

Question 60

Why is a retropharyngeal abscess difficult to diagnose and life-threatening?

Answer 60

There's no external swelling. Abscess can block the airway.

Question 61

Hangman's Fracture

Answer 61

Fracture of dens of C2

Question 62

Location of palatine tonsil

Answer 62

located between palatoglossal and palatopharyngeal arches

Question 63

Acoustic Neuroma (Neurinoma)

Answer 63

Tumor at Internal Auditory Meatus (Blocks CN VII, VIII)

Question 64

Air sinuses in the skull we need to know, all named for the adjacent bone

Answer 64

1) frontal sinus 2) sphenoid sinus 3) ethmoid sinus 4) maxillary sinus

Question 65

Result of damaged tympanic membrane or Petrotympanic fissure

Answer 65

1) loss of taste to anterior 2/3 of tongue | 2) loss of parasympathetics to submandibular and sublingual salivary glands

Question 66

A cause of meningitis. CSF leaks into nose

Answer 66

Fracture of nose can break the cribriform plate, which is part of the floor of anterior cranial fossa

Question 67

"Popcorn 2"; Found lateral to inlet of larynx

Answer 67

piriform recess

Question 68

Cleft lip

Answer 68

failure of fusion of medial nasal process and maxillary process