Head And Neck

Head and Neck

HEAD AND NECK – 2021

Questions from The 2021 Module + Annual Exam of Head and Neck

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“Think about which muscles are involved in speech, swallowing, and the soft palate, and consider how they might be different from those that control jaw movement.”

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Category: Head and Neck – Anatomy

Nucleus ambigous does not give fibers to which of the following?

Intrinsic muscles of larynx

Constrictor muscles of pharynx

Tensor veli palatini

Superior two-thirds of esophagus

Nerve to stylopharyngeus

The nucleus ambiguus is a critical structure located in the medulla of the brainstem, and it is responsible for sending motor fibers to various muscles involved in swallowing, speaking, and other actions related to the pharynx, larynx, and upper esophagus. Let’s examine the roles of this nucleus and the muscles it innervates.

Correct Answer: Tensor veli palatini

The tensor veli palatini is a muscle of the soft palate, involved in the tensing of the soft palate during swallowing and speech. However, it is not innervated by the nucleus ambiguus. Instead, it is innervated by the mandibular branch of the trigeminal nerve (V3).
The nucleus ambiguus sends motor fibers to structures primarily involved in swallowing and vocalization, including muscles of the pharynx, larynx, and upper esophagus, but not the tensor veli palatini.

Why the Other Options Are Incorrect:

Nerve to stylopharyngeus
- The nerve to the stylopharyngeus is innervated by the glossopharyngeal nerve (CN IX), which is connected to the nucleus ambiguus. This muscle elevates the pharynx and aids in swallowing, and motor fibers from the nucleus ambiguus reach it.
- Therefore, this option is incorrect.
Constrictor muscles of pharynx
- The constrictor muscles of the pharynx (superior, middle, and inferior constrictors) are innervated by the vagus nerve (CN X), which receives its motor output from the nucleus ambiguus. These muscles are responsible for constricting the pharynx during swallowing.
- Therefore, this option is incorrect.
Superior two-thirds of esophagus
- The superior two-thirds of the esophagus are innervated by the vagus nerve (CN X), and the motor fibers to these muscles also originate from the nucleus ambiguus. This is important for peristalsis during swallowing.
- Therefore, this option is incorrect.
Intrinsic muscles of larynx
- The intrinsic muscles of the larynx (such as the cricothyroid, lateral cricoarytenoid, etc.) are also innervated by the vagus nerve (specifically the recurrent laryngeal nerve), with motor fibers originating from the nucleus ambiguus.
- Therefore, this option is incorrect.

Key Takeaways:

The nucleus ambiguus provides motor fibers to muscles involved in swallowing and phonation, including the constrictor muscles of the pharynx, muscles of the larynx, and the superior two-thirds of the esophagus.
The tensor veli palatini is the exception—it is not innervated by the nucleus ambiguus but by the mandibular nerve (V3).

“Consider which muscle specifically controls the lifting of the eyelid, and think about how nerve damage to that area would result in difficulty opening the eye.”

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Category: Head and Neck – Anatomy

A person comes to the clinic with complaints of drooping of the right upper eyelid and inability to keep his right eye open. Which of the following muscles is most likely involved?

Orbicularis oculi

Superior rectus

Inferior oblique

Levator palpebrae superioris

Superior oblique

The complaint described here—drooping of the upper eyelid (ptosis) and inability to keep the eye open—points to a dysfunction in the muscle responsible for elevating the upper eyelid. This condition can be indicative of a neurological issue affecting the specific muscle.

Let’s look at the functions of the muscles listed and identify the one most likely involved in this condition:

Correct Answer: Levator palpebrae superioris

The levator palpebrae superioris is the muscle responsible for elevating the upper eyelid. It is innervated by the oculomotor nerve (CN III). Dysfunction of this muscle due to nerve damage or other causes results in ptosis, or drooping of the eyelid. Inability to open the eyelid can occur if this muscle is weakened or paralyzed.
If the levator palpebrae superioris is affected, the eyelid will sag and the individual will have difficulty keeping their eye open. This is consistent with the patient’s complaint.

Why the Other Options Are Incorrect:

Orbicularis oculi
- The orbicularis oculi is responsible for closing the eyelids and is involved in blinking and squinting. It is innervated by the facial nerve (CN VII). Although paralysis of this muscle can cause difficulty closing the eyelid, it does not cause ptosis (drooping of the eyelid), which involves the levator palpebrae superioris.
- Therefore, this option is incorrect.
Inferior oblique
- The inferior oblique is a muscle responsible for upward and outward rotation of the eye. It helps with eye movement, not eyelid elevation. Dysfunction of this muscle would cause problems with eye movement rather than ptosis.
- Therefore, this option is incorrect.
Superior rectus
- The superior rectus muscle is responsible for upward movement of the eye. While its dysfunction can affect eye movement, it does not affect the eyelid. Therefore, it does not contribute to ptosis.
- Therefore, this option is incorrect.
Superior oblique
- The superior oblique muscle is responsible for downward and outward rotation of the eye. Similar to the inferior oblique, it contributes to eye movement, but not eyelid elevation. Dysfunction would affect eye positioning, not the ability to open the eyelid.
- Therefore, this option is incorrect.

Key Takeaways:

Levator palpebrae superioris is the muscle responsible for elevating the upper eyelid. Damage to this muscle or its innervation (via the oculomotor nerve) results in ptosis (drooping eyelid).
The other muscles listed either affect eye movements or eyelid closure, but they do not control eyelid elevation.

“Think about the role of the central region of the retina in providing the sharpest visual detail, and consider which photoreceptors are specialized for such high-resolution tasks.”

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Category: Head and Neck – Anatomy

Which of the following are found abundantly in the fovea?

Rods

Oxyntic cells

Bipolar cells

Cones

Endothelial cells

The fovea is a small, central region in the retina of the eye, known for its role in sharp central vision. It is responsible for activities that require high visual acuity, such as reading and recognizing faces. The fovea is particularly adapted for daylight vision and provides the clearest image of the visual field due to the unique structure and arrangement of its cells.

Correct Answer: Cones

The fovea contains a high density of cones, which are specialized photoreceptor cells responsible for color vision and high-resolution vision. These cones are concentrated in the fovea because this area is primarily used for acute central vision.
Cones are sensitive to bright light and are essential for tasks that require visual detail, such as reading and distinguishing colors.

Why the Other Options Are Incorrect:

Bipolar cells
- Bipolar cells are interneurons in the retina that transmit signals from photoreceptors (rods and cones) to ganglion cells. While bipolar cells are present throughout the retina, they are not the dominant cell type in the fovea. The fovea is primarily populated by cones, with minimal involvement of bipolar cells in terms of number or density.
- Therefore, this option is incorrect.
Rods
- Rods are the photoreceptors responsible for vision in low-light conditions (scotopic vision). They are more abundant in the peripheral regions of the retina and are sparsely distributed in the fovea. The fovea has no rods in its central part, as it is specialized for high acuity vision under bright light, which cones are better suited for.
- Therefore, this option is incorrect.
Oxyntic cells
- Oxyntic cells are located in the stomach and secrete hydrochloric acid (HCl) for digestion. These cells are not found in the retina and have no relation to vision.
- Therefore, this option is incorrect.
Endothelial cells
- Endothelial cells line the inner surface of blood vessels and are involved in regulating blood flow and vascular permeability. They are not directly involved in the process of vision and are not concentrated in the fovea.
- Therefore, this option is incorrect.

Key Takeaways:

The fovea is the part of the retina responsible for sharp, detailed central vision and contains a high concentration of cones.
Cones are responsible for color and high-acuity vision, which makes them abundant in the fovea.
Rods are more concentrated in the periphery and do not play a significant role in the foveal region.

When analyzing arterial supply, trace the pathway of the vessel — does it actually enter the nasal cavity or supply external nasal structures, or does it serve a neighboring region that merely communicates with the nose?

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Category: Head and Neck – Anatomy

The nose has a rich vascular supply. Which of the following arteries does not directly supply the nose?

Descending palatine

Posterior ethmoidal

Sphenopalatine

Anterior ethmoidal

Lateral nasal

Consider how the face is divided for lymphatic drainage purposes. Think: if the face were a map, what “borders” would determine which regions send fluid to which stations? Where would the fluid from the center go versus the corners?

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Category: Head and Neck – Anatomy

A person feels pain when drinking hot tea. On examination, the central part of the lower lip has an ulcer and associated lymph nodes are swollen. Which nodes are involved?

Submandibular nodes

Deep cervical lymph nodes

Superficial cervical lymph nodes

Submental nodes

None of these

Think about which cranial nerve carries both motor fibers to extraocular muscles and autonomic fibers responsible for adjusting the pupil and lens. Trace its path from the brainstem into the orbit.

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Category: Head and Neck – Anatomy

Preganglionic fibers for pupillary reflex reach ciliary ganglion where they synapse and form short ciliary nerves (postganglionic fibers) that innervate the eye. Preganglionic fibers reach ciliary ganglion by which of the following nerves?

Nerve to inferior rectus

Nerve to inferior oblique

Optic nerve

Oculomotor nerve

Nasociliary nerve

When shifting your focus to something close, your eye doesn’t just adjust light entry — it reshapes an internal structure to sharpen focus. Which muscle is directly tied to that reshaping?

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Category: Head and Neck – Anatomy

For near vision, the lens is accommodated to attain increased convexity. Which of the following muscle contracts to help in this action?

Dilator pupillae

Iris

Ciliary muscle

None of these

Sphincter pupillae

One of these bones is part of the orbital and cranial cavity, not the lateral wall of the skull. If you trace the boundaries of where the temporalis muscle lies, which bone doesn’t help form its home?

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Category: Head and Neck – Anatomy

A 20-year-old boy has an accident. In the accident, the floor of the temporal fossa is fractured. Which of the following structures is not affected?

Greater wing of sphenoid

Frontal bone

Squamous part of temporal bone

Parietal bone

Lesser wing of sphenoid

Sometimes, the road to a destination isn’t built by the original owner—it’s handed over to a local guide. Think about which nerve is the local guide that helps someone else’s fibers reach a target they don’t naturally own.

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Category: Head and Neck – Anatomy

A person meets an accident and loses all the salivary activity of the submandibular gland. The preganglionic parasympathetic secretomotor fibers to this gland are carried by which of the following nerves?

Submental nerve

Glossopharyngeal nerve

Auriculotemporal nerve

Lingual nerve

Inferior alveolar nerve

When the upper part of a structure moves like a loose drawer and the hinges below don’t meet their match, the foundation has failed. Think about the architectural framework that holds the middle third of the face steady—and what happens when it’s cracked at its base.

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Category: Head and Neck – Anatomy

A patient has swelling on his face with midface mobility and malocclusion of his teeth with anterior open bite. What kind of fracture is described here/what bone is involved?

Fracture of zygomatic arch

Maxillofacial fracture

None of these

Fracture of nasal bone

Fracture of sphenoid body

When mapping highways of the neck, one splits into city lanes right where the signpost of the voice box stands tall. That intersection divides supply to deeper routes and surface streets—timing and location are everything.

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Category: Head and Neck – Anatomy

Which of the following is true about the common carotid artery?

At the right side, common carotid artery arises from the arch of aorta

It divides into internal and external carotid artery at the upper border of thyroid cartilage

It supplies a branch to the thyroid gland

It has a dilatation on it just after its initiation below the bifurcation

At the left side, common carotid artery arises from the brachiocephalic trunk

In a junction built for face and feeling, only those who climb toward the eye, nose, and palate are welcome. Those diving down to the jaw miss this high-level meeting spot entirely.

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Category: Head and Neck – Anatomy

Which of the following is not a content of the pterygopalatine fossa?

Inferior alveolar artery

Nerve to pterygoid canal

None of these

Pterygopalatine ganglion

Zygomatic nerve

When damage occurs in the factory that controls taste, tears, and expressions, not all nearby muscles are on its payroll. Think carefully about who answers to which boss—even if they work in the same neighborhood.

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Category: Head and Neck – Anatomy

Which of the following will not be affected by damage to the superior salivatory nucleus in the pons and facial nerve nucleus lesion?

Buccinator

Taste sensation from anterior two thirds

Occipito-frontalis

Mylohyoid

Stapedius

Imagine the main pilot goes unconscious mid-flight. Only the side engines are left running—and the doors stay wide open no matter the light outside.

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Category: Head and Neck – Anatomy

A patient suffers damage to the orbit resulting in damage to the third cranial nerve. Which of the following signs will be present?

Pupillary dilatation and abduction of eye

Pupillary dilatation and adduction of eye

Pupillary constriction and adduction of eye

None of these

Pupillary constriction and abduction of eye

When you’re reading a book or walking downstairs, one muscle keeps you from seeing double. If looking down while crossing your eyes causes trouble, find the one nerve that only serves that job—and nothing else.

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Category: Head and Neck – Anatomy

The patient is having diplopia with restricted movements of the eye whenever he depresses or adducts the eye. Which nerve is affected?

Sixth

Third

None of these

Fifth

Fourth

In the symphony of hearing, which structure acts like the piano’s strings — tuned to resonate at just the right frequencies, stretched along a spiraling hallway?

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Category: Head and Neck – Physiology

Vibrations in the cochlear fluid cause vibration in which of the following structures?

Tectorial membrane

None of these

Cupula

Basilar membrane

Otolithic membrane

When you enjoy the sweetness of chocolate or the bitterness of aspirin on the front of your tongue, which nerve makes it poetic, not painful?

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Category: Head and Neck – Anatomy

A person takes aspirin for chest pain. He feels a very strong bitter taste. Which nerve is responsible for carrying taste sensation from the anterior two-thirds of the tongue?

Trigeminal

Hypoglossal

Vagus

Glossopharyngeal

Facial

Think about which secretions keep you breathing comfortably and speaking smoothly. If your nasal and palatal “faucets” are shut off, which ganglion forgot to send the water?

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Category: Head and Neck – Anatomy

A patient comes to the outpatient department with complaints of dryness of nose and palate. Which ganglion must be damaged?

Pterygopalatine ganglion

Nodose ganglion

Otic ganglion

Ciliary ganglion

Submandibular ganglion

In a triangle where vessels and nerves run like highways, a slender muscular “barrier” slices through the space, reshaping the map into zones of higher clinical importance. Which structure plays the role of this internal divider — neither bony nor bellied in the front?

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Category: Head and Neck – Anatomy

Which of the following structures divides the posterior triangle of the neck into two parts?

Superior belly of omohyoid

Inferior belly of omohyoid

Anterior belly of digastric

Greater cornu of hyoid bone

Posterior belly of digastric

In triangles of the neck, always distinguish between bones (which form hard borders for upper triangles) and strap muscles (which define soft, deeper triangles). In the case of the muscular triangle — where the thyroid resides — the lateral edge is carved not by bone, but by a slim band of descending muscle.

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Category: Head and Neck – Anatomy

Which of the following structures is involved in forming the lateral border of the muscular triangle?

Inferior belly of omohyoid

Midline of the neck

Mandible

Superior belly of omohyoid

Hyoid bone

In every triangle, there’s always a base, a point, and an edge that sets the upper limit. If two flexible structures pull from below, what solid landmark forms the ceiling?

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Category: Head and Neck – Anatomy

Which of the following structures forms the superior border of the digastric triangle?

Sternocleidomastoid

Mandible

Inferior belly of omohyoid

Anterior belly of digastric

Hyoid bone

When you raise your shoulders to say “I don’t know,” think about the muscle that fans out like a cape, connecting your neck to your scapula and spine — it’s the one often blamed for tension headaches too.

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Category: Head and Neck – Anatomy

Which of the following muscles is involved in shrugging of shoulders?

Deltoid

Teres major/minor

Supraspinatus

Pectoralis major/minor

Trapezius

If a flavor kicks in the instant it touches your tongue, it’s likely being detected at the frontlines — and when you’re licking a salty potato chip, where does it tingle first?

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Category: Head and Neck – Physiology

A chef adds too much salt to the soup by mistake. Which of the following is the appropriate area of the tongue which detects salty taste?

Anterior U-shaped area of the tongue

Back of the tongue

Almost entire area of tongue ventrally

Sides of the tongue

Tip of the tongue

Our bodies are built to warn us against danger. Where do you think the taste sensors should be located if you want to catch a potentially harmful substance before it reaches the throat?

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Category: Head and Neck – Physiology

A person eats something, which is so bitter that he has to puke it out. Which of the following is the appropriate area of the tongue which detects bitter taste?

Almost entire area of tongue ventrally

Sides of the tongue

Anterior U-shaped area of the tongue

Back of the tongue

Tip of the tongue

“Think about how umami is a ‘savory’ taste found in many foods—would it make sense for its detection to be limited to one small area, or spread more widely?”

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Category: Head and Neck – Physiology

A person eats something and finds it to have a delicious taste called umami. Which of the following is the appropriate area of the tongue which detects umami taste?

Almost entire area of tongue ventrally

Tip of the tongue

Anterior U-shaped area of the tongue

Back of the tongue

Sides of the tongue

When something tangy hits your tongue and makes your mouth pucker, the response isn’t coming from the frontlines or the deep rear — it’s the edges that sound the acid alarm.

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Category: Head and Neck – Physiology

A man plans to lose weight so he cuts off calories and makes a salad for himself. Upon tasting it, he finds out that there is too much lemon in it. Which of the following is the appropriate area of the tongue which detects sour taste?

Back of the tongue

Sides of the tongue

Tip of the tongue

Almost entire area of tongue ventrally

Anterior U-shaped area of the tongue

Think about where a candy or sweet first delights your tongue — it’s that very first contact point, where kisses land and sugar hits first.

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Category: Head and Neck – Physiology

A person eats something which is very sweet. Which of the following is the appropriate area of the tongue which detects sweet taste?

Anterior U-shaped area of the tongue

Tip of the tongue

Back of the tongue

Sides of the tongue

Almost entire area of tongue ventrally

“When considering intracranial complications of ear infections, which thin bony structure acts as a barrier between the mastoid air cells and the brain?”

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Category: Head and Neck – Anatomy

Which of the following is correct regarding mastoid air cells and mastoid antrum?

Suprameatal triangle is antero-inferior to the mastoid process

Mastoid air cells or antrum opens on the posterior wall of external ear

None of these

Mastoid antrum is separated from middle cranial fossa by tegmen tympani

The canal for facial nerve is below the aditus to the mastoid antrum

This channel silently manages the fluid that keeps the front of your eye pressurized and clear — and its wall is built like the innermost lining of most pipes that transport fluid without carrying blood.

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Category: Head and Neck – Anatomy

Which of the following is true about the canal of Schlemm?

It is lined by stratified squamous epithelium

None of these

It is lined by endothelium

It contains red cells

It communicates with the vitreous chamber

Imagine a nerve that’s all action and no sensation, slipping out from the motor highway of the medulla. If its signal is silenced, even the most basic movement of speech and swallowing becomes a chore — what part of the tongue does this impact most directly?

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Category: Head and Neck – Anatomy

A 45-year-old male is diagnosed with a brain tumor that is pressing on the nerve that passes through a groove between pyramids and olives. Which of the following functions would be affected?

General sensations on the ipsilateral side of the anterior two thirds of a tongue

Paralysis of all the extrinsic muscles of the tongue only

Taste on the ipsilateral side of the posterior one third of a tongue

Paralysis of all the intrinsic muscles of the tongue

Taste on the ipsilateral side of the anterior two thirds of a tongue

Think of the nervous system like a department store: temperature signals don’t go to the fancy showroom (touch and pressure), nor to the gym (proprioception), nor the staff lounge (motor control). They head to the basement — where pain and heat are processed. Which “basement-level” nucleus does that sound like?

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Category: Head and Neck – Anatomy

Which of the following carries a sense of temperature directly from the anterior two-thirds of a tongue to the thalamus?

Motor nucleus of trigeminal nerve

Spinal nucleus of trigeminal nerve

Ventro postero lateral nucleus of thalamus

Mesencephalic nucleus of trigeminal nerve

Main sensory nucleus of trigeminal nerve

“Which cells monitor the body’s fluid balance and trigger thirst or ADH release when blood becomes too concentrated? Think about how the brain ‘senses’ internal pressure changes.”

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Category: Head and Neck – Anatomy

Which of the following cells of the brain detect pressure?

Schwann cells

Astrocytes

Oligodendrocytes

Ependymal cells

Osmoreceptors

When infection strikes the neck’s deep highway tunnel, which vital structure — running straight up toward the brain and pulsing with each beat — is caught right in the center lane?

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Category: Head and Neck – Anatomy

A physician found an infection involving carotid sheath. Which of the following structures might be involved?

Recurrent laryngeal nerve

External jugular vein

Common carotid artery

Sympathetic chain

Ansa cervicalis

Structure	Location in Sheath
I: Internal Jugular Vein	Lateral
C: Common Carotid Artery	Medial
10: Vagus Nerve (CN X)	Posterior between the artery and vein

When building a dividing wall from the roof to the floor of a narrow passage, which two bones — one dropping down from above, the other rising up from below — would you expect to meet in the middle?

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Category: Head and Neck – Anatomy

Which of the following sets of bones have a major contribution to the nasal septum?

Maxillary and palatine bone

Lacrimal and sphenoidal bones

Nasal cartilage and nasal bone

Inferior and superior nasal conchae

Vomer and perpendicular plate of ethmoid

Trace the path of a vessel that emerges from a canal in the mandible to reach the skin—what exits with sensation often travels with circulation.

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Category: Head and Neck – Anatomy

A 10-year-old boy came to the emergency department with a laceration on the tip of the chin which is bleeding. Which of the following arteries must be affected?

Buccal artery

Transverse facial artery

Infraorbital artery

Maxillary artery

Mental artery

If you wanted to hide a powerful chewing muscle, a major artery, and a nerve that numbs the jaw—all in one deep, protected space—where would you build that chamber?

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Category: Head and Neck – Anatomy

Which of the following lies posterior to the maxilla, inferior and deep to the zygomatic arch and ramus of the mandible?

Middle cranial fossa

Temporal fossa

Pterygopalatine fossa

Middle cranial fossa

Infratemporal fossa

“Imagine trying to peer into a tiny cave hidden behind the cheekbone—which angle would let you see its entrance clearly without obstruction?”

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Category: Head and Neck – Anatomy

From which view can pterygopalatine fossa be seen best?

Norma frontalis

Norma occipitais

Norma basalis

Norma lateralis

Norma verticalis

If your windshield wiper fluid stops working, it’s not the motor—you might want to check the switchboard deep in the face that connects signals from a petrosal source.

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Category: Head and Neck – Anatomy

Xeropthalmia is defined as dryness of the eye. Damage to which of the following structures can cause xeropthalmia?

Ciliary ganglion

Pterygopalatine ganglion

Otic ganglion

Submandibular ganglion

Superior cervical ganglion

If one pulley snaps on a marionette, and now it can’t look down when pulled inward, which string was it?

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Category: Head and Neck – Anatomy

Which of the following muscles would be affected in case the trochlear nerve gets damaged?

Superior rectus

Inferior oblique muscle

Superior oblique muscle

Lateral rectus

Medial rectus

This point lies posteriorly and laterally, near the base of the skull, behind the ear. It’s where the temporal, occipital, and parietal bones meet.

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Category: Head and Neck – Anatomy

While examining the lateral view of the X-ray of the skull, a radiologist points out a region that is the meeting point of the parietomastoid, occipitomastoid, and lambdoid sutures. What point is he referring to?

Lambda

Pterion

Asterion

Bregma

Inion

This lymph node is sometimes nicknamed the “tonsillar node” and is notoriously enlarged in tonsillitis. It lies just below and behind the angle of the mandible, near a muscle that helps dig.

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Category: Head and Neck – Anatomy

The lymphatic drainage from the palatine tonsil drains into which of the following lymph nodes?

Submental

Submandibular

Deep cervical

Jugulodigastric

Superficial cervical

The tiny bones in your middle ear need to transmit sound vibrations very precisely and with minimal friction. What kind of joint allows for small, smooth movements while still maintaining articulation?

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Category: Head and Neck – Anatomy

The auditory ossicles articulate through which kind of joint?

Fibrous joint

Synovial joint

Fibrocartilaginous joint

Cartilaginous joint

Syndesmoses

This foramen is tiny but mighty—it’s associated with a major epidural hematoma risk. Which artery travels through it to reach the cranial cavity?

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Category: Head and Neck – Anatomy

Which of the following branches of the maxillary artery passes through the foramen spinosum?

Nasopalatine artery

Middle meningeal artery

Accessory meningeal artery

Sphenopalatine artery

Greater palatine artery

This artery runs horizontally across the face, just below the zygomatic arch, and accompanies the parotid duct. Which artery runs just above it and gives off this small, transverse branch?

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Category: Head and Neck – Anatomy

The transverse facial artery is a branch of which of the following?

Posterior auricular artery

Superficial temporal artery

Maxillary artery

Occipital artery

Facial artery

The tongue drains into multiple nodes depending on its region (tip, sides, base). But there’s one specific node at the level of the intermediate tendon of a certain muscle that’s known as the “principal node of the tongue.”

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Category: Head and Neck – Anatomy

Lymph from tongue drain in which of the following lymph nodes?

Jugulodigastric

Supraclavicular

Submental

Jugulo-omohyoid

Deep cervical

Most facial bones come in left and right pairs. But there are two key exceptions that are single, midline bones—one above the mouth and one below it.

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Category: Head and Neck – Anatomy

A young man had a car accident and came to the emergency room (ER) with a fracture of a facial bone that is unpaired. Which bone is involved?

Mandible bone

Lacrimal bone

Zygomatic bone

Nasal bone

Maxillary bone

Bone	Paired?	Location/Function
Nasal bone	✅ Yes	Two small bones form the bridge of the nose
Maxillary bone	✅ Yes	Two bones form the upper jaw and part of orbit
Lacrimal bone	✅ Yes	Small bones at the medial wall of the orbits
Zygomatic bone	✅ Yes	Cheekbones; part of zygomatic arch and orbit

The optic canal is a tight passage through the sphenoid bone, transmitting structures directly to the posterior part of the orbit. Only two major structures pass through it—one nerve and one artery.

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Category: Head and Neck – Anatomy

Which of the following is present in the optic canal?

Infraorbital nerve

Ophthalmic artery

Frontal nerve

Abducens nerve

Lacrimal artery

Structure	Why It’s Incorrect	Passes Through
Abducens nerve	Passes through the superior orbital fissure	Not the optic canal
Lacrimal artery	A branch of the ophthalmic artery	Travels laterally after optic canal
Frontal nerve	Branch of ophthalmic division of CN V₁	Also passes through superior orbital fissure
Infraorbital nerve	Branch of maxillary nerve (V₂)	Passes through infraorbital foramen, not optic canal

The carotid sheath is like a protective sleeve around some of the most important neurovascular structures in the neck. But one major superficial vein runs outside this sheath.

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Category: Head and Neck – Anatomy

Which is not present in the carotid sheath?

Internal jugular vein

Internal carotid artery

Common carotid artery

Vagus nerve

External jugular vein

This foramen is found just below the orbit, and it allows the passage of the infraorbital nerve, artery, and vein—structures that emerge to supply the midface, particularly the upper cheek, lower eyelid, and upper lip.

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Category: Head and Neck – Anatomy

The infraorbital foramen is an opening in which of the following bones?

Ethmoid bone

Maxillary bone

Zygomatic bone

Frontal bone

Greater wing of the sphenoid bone

Bone	Why Incorrect
Ethmoid bone	Forms the medial wall of the orbit; contains ethmoidal air cells and foramina, not the infraorbital foramen.
Zygomatic bone	Forms the cheekbone and lateral orbital wall, but does not house the infraorbital foramen.
Greater wing of sphenoid	Forms part of the cranial floor and lateral orbital wall, not the anterior face.
Frontal bone	Forms the forehead and superior orbital rim, not the region below the orbit.

The mandibular nerve (V₃) supplies the muscles of mastication. But one of these muscles, although located in the cheek, has nothing to do with chewing—it helps blow, whistle, and keep food between the teeth, not bite.

50 / 115

Category: Head and Neck – Anatomy

Which of the following muscles is not supplied by the mandibular nerve?

Lateral pterygoid

Medial pterygoid

Temporalis

Masseter

Buccinator

Muscle	Function
Masseter	Elevates mandible (closes jaw)
Temporalis	Elevates and retracts mandible
Medial pterygoid	Elevates and protracts mandible
Lateral pterygoid	Depresses and protracts mandible

The palatine aponeurosis acts like a tendinous sheet for the soft palate. Which muscle, based on its name, is pulling or tensing the soft palate and contributing directly to its structure?

51 / 115

Category: Head and Neck – Anatomy

Which muscle takes part in the formation of palatine aponeurosis?

Tensor veli palatini

Musculus uvulae

Palatopharyngeus

Tensor tympani

Palatoglossus

Muscle	Why Incorrect
Musculus uvulae	Inserts into the aponeurosis, but doesn’t form it
Palatoglossus	Inserts into the side of the tongue, doesn’t form aponeurosis
Palatopharyngeus	Inserts into pharynx and aponeurosis; helps in function but not in formation
Tensor tympani	Muscle of middle ear, not involved in soft palate at all

The infratemporal fossa is a deep space beneath the zygomatic arch and behind the maxilla. Now ask yourself: which side of the fossa lies next to the ramus of the mandible, forming the outermost wall?

52 / 115

Category: Head and Neck – Anatomy

A person injures his mandible (ramus) in an accident. Which boundary of the wall of the infratemporal fossa does it form?

Anterior wall

Posterior wall

Lateral wall

Inferior wall

Medial wall

Option	Why Incorrect
Posterior wall	Formed by styloid process and temporal bone
Inferior wall	Open (leads to other spaces); no bony floor
Medial wall	Formed by lateral pterygoid plate of sphenoid
Anterior wall	Formed by posterior surface of maxilla

This suture junction is located posterolaterally, near the mastoid region, and is important in surgical approaches to the posterior cranial fossa.

53 / 115

Category: Head and Neck – Anatomy

In lateral view of an X-ray of the head, a physician notices the meeting point of parietooccipital, occipitomastoid, and lambdoid sutures. What is this point called?

Pterion

Lambda

Asterion

Bregma

Inion

Point	Sutures Meeting	Location	Incorrect Because…
Inion	Not a suture point (EOP landmark)	Midline occipital bone	It’s a bony projection, not a suture meeting point
Lambda	Sagittal + Lambdoid	Midline at back of skull	Too midline, not lateral
Pterion	Frontal + Parietal + Sphenoid + Temporal	Anterolateral skull	Located above zygomatic arch, unrelated sutures
Bregma	Sagittal + Coronal	Midline at top of skull	At the top front, not posterolateral

Most of the face is supplied by branches of the trigeminal nerve (CN V). But the angle of the mandible is an exception—it’s not covered by CN V.

54 / 115

Category: Head and Neck – Anatomy

Which of the following nerves provide sensory supply to the skin overlying the angle of the mandible?

Greater auricular nerve

Lesser occipital nerve

Greater occipital nerve

Maxillary branch of trigeminal nerve

Mandibular branch of trigeminal nerve

Nerve	Why Incorrect
Mandibular (V₃)	Supplies lower face, chin, temple—but not the angle of the mandible.
Maxillary (V₂)	Supplies midface, upper lip, cheek—not relevant here.
Lesser occipital nerve	Supplies posterior auricle and lateral occiput, not the jaw angle.
Greater occipital nerve	Supplies posterior scalp, far from mandible.

If the eye is resting in a “down and out” position, think: which muscles are not working? What nerve controls the majority of extraocular muscles?

55 / 115

Category: Head and Neck – Anatomy

A person presents with his right eye looking “down and out” with double vision (diplopia) when looking at the right. He has a lesion in which of the following nerves?

Left trigeminal nerve

Left trochlear nerve

Right oculomotor nerve

Right trochlear nerve

Left oculomotor nerve

Option	Why Incorrect
Right trochlear nerve	Lesion causes vertical diplopia on looking down, not “down and out”
Left trigeminal nerve	Affects facial sensation, not eye movement
Left trochlear nerve	Would affect left eye, not right
Left oculomotor nerve	Would affect left eye, not right

These lymph nodes lie just beneath the body of the mandible, tucked between the anterior and posterior bellies of a certain muscle—what is that triangle called?

56 / 115

Category: Head and Neck – Anatomy

The submandibular lymph nodes are present in which triangle?

Digastric triangle

Muscular triangle

Submental triangle

Carotid triangle

Omohyoid triangle

Triangle	Contents	Why Incorrect
Submental triangle	Submental lymph nodes (not submandibular)	Lies below chin, between anterior digastrics
Muscular triangle	Infrahyoid muscles, thyroid gland	No major lymph nodes here
Carotid triangle	Common carotid, IJV, vagus, hypoglossal	No submandibular lymph nodes
Omohyoid triangle	Not a standard triangle name; possibly referencing inferior carotid triangle	Not relevant here

If a blow comes from the front, what direction will the mandibular condyle likely move?

57 / 115

Category: Head and Neck – Anatomy

A man received a strong blow to the anterior aspect of the mandible during a fight. The tympanic plate of the external auditory meatus was affected. The temporomandibular joint has undergone which type of dislocation?

Lateral

Posterior

Superior

Type of Dislocation	Why Incorrect
Superior	Very rare; would require a vertical force. Could fracture the glenoid fossa and enter the cranial cavity—usually from extreme trauma.
Medial	Would result from lateral force; does not affect the tympanic plate.
Anterior	Most common type of TMJ dislocation, but happens due to wide mouth opening or yawning—not from a blow to the anterior mandible.
Lateral	Rare; usually requires significant force from the opposite side or a fracture. Not associated with tympanic plate injury.

Which large neck muscle runs obliquely across the side of the neck and is used as a boundary landmark for both triangles?

58 / 115

Category: Head and Neck – Anatomy

A student is studying about a muscle that forms the boundaries of both anterior and posterior triangles. Which of the following is the appropriate muscle?

Suprahyoid

Sternocleidomastoid

Trapezius

Levator scapulae

Infrahyoid

Muscle	Why Incorrect
Levator scapulae	Lies deep in the posterior triangle only, not anterior.
Suprahyoid muscles	Located within the anterior triangle, not its boundary.
Infrahyoid muscles	Also lie in the anterior triangle, specifically in the muscular subdivision.
Trapezius	Forms the posterior boundary of the posterior triangle, but not part of anterior triangle.

Your eye can close gently (like blinking) or tightly (like squeezing shut when something’s flying toward it). Which part of the muscle handles tight clenching?

59 / 115

Category: Head and Neck – Anatomy

Which of the following muscles causes forceful closure of the eyes?

Orbital part of orbicularis oculi

Palpebral part of orbicularis oculi

Lacrimal part of orbicularis oculi

None of them

Procerus

Option	Why Incorrect
Procerus	Wrinkles the skin over the bridge of the nose; no role in eye closure.
None of them	Incorrect—orbital part of orbicularis oculi clearly performs this function.
Lacrimal part of orbicularis oculi	Helps with tear drainage—not eyelid movement.
Palpebral part of orbicularis oculi	Causes gentle closure, not forceful.

The superior orbital fissure transmits most of the nerves responsible for eye movement, but there’s one major nerve that takes a different route

60 / 115

Category: Head and Neck – Anatomy

Which structure does not pass through the superior orbital fissure?

Abducens nerve

Superior ophthalmic vein

Oculomotor nerve

Trochlear nerve

Optic nerve

Structure	Role
Oculomotor nerve (CN III)	Eye muscle control
Trochlear nerve (CN IV)	Superior oblique muscle
Abducens nerve (CN VI)	Lateral rectus muscle
Superior ophthalmic vein	Venous drainage from orbit
Branches of ophthalmic nerve (CN V₁)	Sensory to eye/forehead

Option	Passes Through SOF?	Reason
Abducens nerve	✅ Yes	Supplies lateral rectus
Superior ophthalmic vein	✅ Yes	Drains blood from orbit
Oculomotor nerve	✅ Yes	Supplies most extraocular muscles
Trochlear nerve	✅ Yes	Supplies superior oblique muscle

Most parts of the face drain safely, but some regions have pathways that bypass filters like lymph nodes and head straight to the brain. If squeezing a pimple could lead to something much worse than scarring, what’s unique about the drainage here?

61 / 115

Category: Head and Neck – Anatomy

A girl is facing pre-pubertal acne. The doctor warns her about not squeezing any pimples and prescribes her some special cream for the tip of the nose and the upper lip region acne. What is the most likely reason?

This area is richly vascularized

This area requires more special care than the others

This area is more prone to acne

None of these

This area has direct dural venous drainage

Option	Why Incorrect
This area requires more special care	Too vague; doesn’t explain the risk
This area is more prone to acne	Acne may occur elsewhere more frequently (like the T-zone), but this is not the key reason for concern here
This area is richly vascularized	True, but many areas are; the issue is the type of venous drainage, not richness
None of these	Incorrect because one option is clearly correct

The pterygopalatine fossa sits deep in the face—like a hidden room—behind the maxilla and below the orbit. Ask yourself: what major structures enter this fossa from the lateral side via the pterygomaxillary fissure?

62 / 115

Category: Head and Neck – Anatomy

Which of the following structures pass through the lateral wall of the pterygopalatine fossa?

Inferior alveolar artery

Terminal branches of maxillary artery

Maxillary nerve

Branches of facial artery

Deep temporal arteries

Option	Why Incorrect
Maxillary nerve	Enters the fossa through the foramen rotundum via the posterior wall, not lateral wall.
Inferior alveolar artery	Branch of maxillary artery, but it travels into the mandibular canal, not the pterygopalatine fossa.
Branches of facial artery	Facial artery runs superficially in the face—not related to the pterygopalatine fossa.
Deep temporal arteries	Supply temporalis muscle; run in the infratemporal fossa, not through the pterygopalatine fossa.

This fossa is a “deep room” located well.. in a place.. What bone or plate forms the front wall of this space?

63 / 115

Category: Head and Neck – Anatomy

Which of the following structures forms the anterior wall of the pterygopalatine fossa?

Infratemporal fossa

Posterior surface of maxilla

Lateral pterygoid plate

Medial pterygoid plate

Zygomatic arch

Option	Why Incorrect
Zygomatic arch	Located laterally and superficially in the face—not part of the pterygopalatine fossa.
Medial pterygoid plate	Forms part of the medial wall or posterior boundary—not the anterior wall.
Infratemporal fossa	A neighboring space, not a structural wall. It communicates laterally with the fossa.
Lateral pterygoid plate	Forms the posterior or lateral boundary of the infratemporal fossa, not the anterior wall of the pterygopalatine fossa.

Only one part of the mandible fits into the mandibular fossa of the temporal bone and allows the jaw to open, close, and move side to side. Which part acts like a hinge and sliding surface?

64 / 115

Category: Head and Neck – Anatomy

Which part of the mandible forms the temporomandibular joint?

Ramus

Condylar process

Coronoid process

Body

Angle

Option	Why Incorrect
Coronoid process	Anterior projection of mandible; muscle attachment (temporalis), not involved in the joint.
Ramus	Vertical part of mandible containing the condylar and coronoid processes, but does not directly form the joint.
Body	Horizontal portion; contains teeth—not part of TMJ.
Angle	Junction between body and ramus—not part of TMJ articulation.

Some branches come straight off the trunk, while others are further downstream—they branch from branches. Ask yourself: which one of these is a “grandchild” of the external carotid, not a “child”?

65 / 115

Category: Head and Neck – Anatomy

Which of the following is not a direct branch of the external carotid artery?

Lingual artery

Ascending pharyngeal artery

Maxillary artery

Facial artery

Sphenopalatine artery

Mnemonic Part	Branch Name
S	Superior thyroid artery
A	Ascending pharyngeal
L	Lingual artery
F	Facial artery
O	Occipital artery
P	Posterior auricular
M	Maxillary artery
S	Superficial temporal

Option	Explanation
Ascending pharyngeal	Smallest direct branch—supplies pharynx and prevertebral muscles
Lingual artery	Supplies the tongue and floor of the mouth
Facial artery	Supplies superficial face
Maxillary artery	One of the two terminal branches (with superficial temporal)

The optic disc is your camera’s blind spot. The macula is your retina’s high-definition center. Where would it need to be placed relative to the blind spot to allow central vision?

66 / 115

Category: Head and Neck – Anatomy

What is the position of the macula lutea relative to the optic disc in the eyeball?

Inferior

Lateral

Superior

Option	Why Incorrect
Inferior	Macula is not below the optic disc.
Superior	Macula is not above the optic disc.
Anterior	Refers to a direction toward the front of the eye—not applicable within the retina.
Medial	Medial would mean nasal side, but the macula is on the temporal (lateral) side of the optic disc.

This nerve enters the mandibular foramen just medial to the retromolar triangle/fossa. It supplies all the lower teeth on that side. What nerve would a dentist target for mandibular block anesthesia?

67 / 115

Category: Head and Neck – Anatomy

Anesthesia in retromolar fossa primarily blocks which of the following nerves?

Lingual nerve

Inferior alveolar nerve

Buccal nerve

Submandibular nerve

Mental nerve

Nerve	Why Incorrect
Submandibular nerve	No such nerve exists; possibly confusion with submandibular ganglion, which is parasympathetic.
Lingual nerve	Runs anterior and medial to the inferior alveolar nerve; anesthesia in the retromolar fossa may also affect it slightly, but it’s not the primary target.
Mental nerve	A terminal branch of the inferior alveolar nerve; exits at the mental foramen, not affected by proximal injection.
Buccal nerve	Supplies cheek mucosa, but is not anesthetized through retromolar fossa injection; requires separate block.

The carotid sheath is like a “vertical sleeve” in the neck that encloses key structures. It’s formed by blending of the three main deep cervical fascia layers. But which named sheath in this list is not even part of this cervical fascial system?

68 / 115

Category: Head and Neck – Anatomy

Which of the following does not take part in the formation of the carotid sheath?

Investing layer of fascia

None of these

Pretracheal layer of fascia

Prevertebral layer of fascia

Parotid gland sheath

Layer/Structure	Role in Carotid Sheath Formation
Investing layer of fascia	✅ Contributes to lateral wall
Pretracheal fascia	✅ Forms anterior part
Prevertebral fascia	✅ Forms posterior part
None of these	❌ One option (parotid gland sheath) is clearly correct

Which nerve runs within the mandible itself, passing through the mandibular canal and exiting at the mental foramen? That’s the one most at risk in fractures of the mandibular body or ramus.

69 / 115

Category: Head and Neck – Anatomy

Fracture of mandible most likely results in the damage of which of the following nerves?

Submandibular nerve

Buccal nerve

None of these

Lingual nerve

Inferior alveolar nerve

Nerve	Why Incorrect
Lingual nerve	Lies medial to the mandible, near the third molar—may be injured during extractions, but less likely in fractures.
Buccal nerve	Lies superficially over the buccinator; not in contact with the mandible.
Submandibular nerve	No such named nerve. Possibly refers to fibers from the chorda tympani to submandibular ganglion—but not directly related to bone.
None of these	Incorrect, since inferior alveolar nerve is clearly at risk in mandibular fractures.

This nerve is a branch of the facial nerve, but it also hitchhikes on another nerve to reach its target. It carries taste fibers and preganglionic parasympathetic fibers to a ganglion involved in salivation.

70 / 115

Category: Head and Neck – Anatomy

A nerve winds around the styloid process and carries postganglionic parasympathetic fibers which stimulate salivary secretion in the submandibular and sublingual glands. What is the name of the given nerve?

Chorda tympani

Deep petrosal nerve

Lingual nerve

Facial nerve

Buccal nerve

Option	Why Incorrect
Facial nerve	The main trunk gives off the chorda tympani, but it doesn’t directly supply the glands.
Buccal nerve	Sensory branch of CN V₃; no parasympathetic or salivary function.
Lingual nerve	Carries postganglionic fibers after receiving them from chorda tympani—but doesn’t originate the salivary stimulation.
Deep petrosal nerve	Carries sympathetic fibers to lacrimal/nasal mucosa—not salivary glands.

It’s the largest paranasal sinus and its drainage opening is high up on one of its walls, which is why infections like sinusitis are common—it doesn’t drain easily. Where is this opening located?

71 / 115

Category: Head and Neck – Anatomy

Maxillary sinus drains into which of the following?

Inferior nasal meatus

Middle nasal meatus

Spheno-ethmoidal recess

Superior nasal meatus

Semilunar hiatus

Option	Why Incorrect
Inferior nasal meatus	Drains the nasolacrimal duct, not any sinus.
Spheno-ethmoidal recess	Drains the sphenoid sinus, not the maxillary.
Superior nasal meatus	Drains posterior ethmoidal air cells, not the maxillary sinus.
Semilunar hiatus	This is the structure within the middle meatus—not a meatus itself. So while anatomically related, “middle nasal meatus” is the most correct answer here.

“Consider the destinations: which of these structures serves regions beyond the ear and doesn’t need to take the same corridor as nerves concerned with balance, hearing, and facial movement?”

72 / 115

Category: Head and Neck – Anatomy

Which of the following structures does not pass through the internal acoustic meatus?

Labyrinthine artery

Vestibular division of 8th cranial nerve

Facial nerve

Cochlear division of 8th cranial nerve

Glossopharyngeal nerve

Let’s start by understanding what the internal acoustic meatus (IAM) is:

The IAM is a canal in the petrous part of the temporal bone.
It serves as a passageway connecting the posterior cranial fossa to the inner ear structures.
Its primary function is to transmit nerves and vessels to the inner ear and the facial canal.

Structures that pass through the internal acoustic meatus:

Facial nerve (CN VII):
- Enters the IAM, then travels in the facial canal to exit at the stylomastoid foramen.
Vestibulocochlear nerve (CN VIII):
- Splits into:
  - Vestibular division (balance)
  - Cochlear division (hearing)
Labyrinthine artery:
- A branch (usually from the anterior inferior cerebellar artery, AICA) that accompanies CN VII and CN VIII to supply the inner ear.

So, these three — facial nerve, vestibular nerve, cochlear nerve, and labyrinthine artery — all enter the internal acoustic meatus together.

Now, the glossopharyngeal nerve (CN IX):

Exits the cranial cavity via the jugular foramen, NOT the internal acoustic meatus.
It supplies sensory and motor innervation to the pharynx, tongue, and other structures.

Therefore, the glossopharyngeal nerve does NOT pass through the internal acoustic meatus.

❌ Why the other options are incorrect:

Option	Why it’s incorrect (i.e., why it DOES pass through IAM)
Vestibular division of CN VIII	It passes through the IAM to reach the vestibular apparatus (for balance).
Facial nerve	It enters IAM before traveling through the facial canal to exit at the stylomastoid foramen.
Cochlear division of CN VIII	It passes through IAM to reach the cochlea (for hearing).
Labyrinthine artery	It travels through IAM alongside CN VII and CN VIII to supply the inner ear.

📝 Key takeaway:

Only nerves destined for the inner ear and the facial nerve pass through the internal acoustic meatus. The glossopharyngeal nerve is not involved in this pathway.

“Ask yourself: which structure is functionally opposite to the one that closes the eyelid? And what nerve would control such an action?”

73 / 115

Category: Head and Neck – Anatomy

Which muscle must be affected if the upper eyelid is droopy (ptosis)?

Palpebral part of orbicularis oculi

Medial rectus

Superior rectus

Inferior tarsus

Orbital part of orbicularis oculi

✅ Correct Answer: Palpebral part of orbicularis oculi

Actually, not quite! → The truly correct answer should be levator palpebrae superioris, but since it’s not listed, the closest relevant structure is the palpebral part of orbicularis oculi—and that’s a trick here, because neither orbicularis oculi nor its parts are elevators of the eyelid; rather, they close the eyelid.

Therefore, to understand what’s wrong with the options, we need to walk through them carefully.

🎓 Explanation:

Ptosis = drooping of the upper eyelid.
→ To identify the muscle affected, we need to know which muscle elevates the upper eyelid.

1️⃣ Main elevator of the upper eyelid:

Levator palpebrae superioris (innervated by oculomotor nerve, CN III)
- This is the primary muscle that lifts the upper eyelid.

2️⃣ Additional minor elevator:

Superior tarsal muscle (Müller’s muscle): smooth muscle innervated by sympathetic fibers (adds tone to keep eyelid elevated).

Now let’s evaluate each option:

Option	Role	Relation to eyelid drooping
A) Orbital part of orbicularis oculi	Closes the eyelid forcefully (squinting); not responsible for elevation	Paralysis would impair closure, not cause ptosis
B) Palpebral part of orbicularis oculi	Closes eyelid gently (blinking); also not an elevator	Damage → incomplete closure, not ptosis
C) Inferior tarsus	This is a connective tissue plate, not a muscle	Not responsible for movement → irrelevant
D) Medial rectus	Moves eyeball medially → no function in eyelid movement	Damage → eye movement deficit, no ptosis
E) Superior rectus	Moves eyeball upward → no direct role in eyelid elevation	Damage → impaired upward gaze, no ptosis

👉 What’s missing?
The actual muscle causing ptosis is levator palpebrae superioris, innervated by CN III.
Alternatively, sympathetic damage → ptosis via superior tarsal muscle (as in Horner’s syndrome).

Since none of these muscles are elevators, none of the options directly cause ptosis if paralyzed.

❌ Why each option is wrong (and what they actually do):

Orbital part of orbicularis oculi:
→ closes eye tightly (squinting); damage → eye stays open, not ptosis.
Palpebral part of orbicularis oculi:
→ closes eye gently; damage → impaired blinking, not ptosis.
Inferior tarsus:
→ structural tissue, no muscle action.
Medial rectus:
→ moves eye medially; no action on eyelid.
Superior rectus:
→ moves eye upward; no eyelid action.

✅ Therefore, none of these are correct if we strictly stick to anatomy.

However, in an exam setting, if forced to choose, the palpebral part of orbicularis oculi is the least incorrect because it at least relates to eyelid movement, even if it causes closure instead of elevation.

📝 Key takeaway:

Ptosis = dysfunction of levator palpebrae superioris (CN III) or superior tarsal muscle (sympathetics).
Orbicularis oculi closes the eyelid; paralysis = inability to close, not drooping.

“Consider which air cells are large enough and positioned to create a visible bulge in the middle meatus—what lies beneath the elevation itself?”

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Category: Head and Neck – Anatomy

Ethmoidal bulla can be seen in the middle nasal meatus. Which of the following is related to ethmoidal bulla?

Inferior ethmoidal sinus

Superior ethmoidal sinus

Maxillary sinus

Frontal sinus

Middle ethmoidal sinus

Option	Reason it’s incorrect
A) Maxillary sinus	Drains into the middle meatus → but via the hiatus semilunaris, below the bulla, not into the bulla itself.
B) Frontal sinus	Drains into the middle meatus → via the infundibulum, which connects to the hiatus semilunaris, anterior and superior to the bulla, but not directly onto it.
C) Superior ethmoidal sinus	Drains into the superior meatus, above the bulla, not onto the bulla.
E) Inferior ethmoidal sinus	No such anatomical term exists; the ethmoidal sinuses are classified as anterior, middle, and posterior—not “inferior.”

“Consider which pathway is responsible for detecting light and carrying that information toward the brain, rather than controlling the response to it.”

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Category: Head and Neck – Anatomy

Damage to which of the following structures can cause relative afferent pupillary defect (RAPD)?

Optic nerve

Trochlear nerve

Abducent nerve

Occulomoter nerve

Superficial temporal nerve

✅ Correct Answer: Optic nerve

Let’s start by understanding what a relative afferent pupillary defect (RAPD) is:

RAPD (also known as Marcus Gunn pupil) is a condition where the affected eye has reduced afferent input to the brain’s visual system, specifically in the pathway responsible for the pupillary light reflex.
Clinically detected using the swinging flashlight test: when the light moves from the normal eye to the affected eye, the pupils paradoxically dilate instead of constricting, because less light input is perceived from the affected side.

👉 Key principle: RAPD indicates a lesion in the afferent limb of the pupillary light reflex.

🧠 Anatomy of the pupillary light reflex:

Afferent limb → optic nerve (CN II) → pretectal nuclei → Edinger-Westphal nuclei
Efferent limb → oculomotor nerve (CN III) → ciliary ganglion → sphincter pupillae muscle (pupil constriction)

Damage to the afferent limb (optic nerve) reduces the perception of light, leading to an RAPD.

✅ Optic nerve is correct:

The optic nerve carries visual information and the afferent signals of the pupillary light reflex from the retina to the brainstem.
Damage → impaired signal → reduced or absent perception of light stimulus → RAPD.

Common causes include:

Optic neuritis (seen in multiple sclerosis)
Ischemic optic neuropathy
Severe retinal disease

❌ Why the other options are incorrect:

Option	Why it’s incorrect
Oculomotor nerve	Efferent limb → controls pupil constriction (motor output). Damage causes dilated pupil (fixed), ptosis, eye deviation, but does not cause RAPD.
Trochlear nerve	Innervates superior oblique muscle → involved in eye movement, not in pupillary reflex. Damage → vertical diplopia, no RAPD.
Superficial temporal nerve	Branch of mandibular division of CN V (V3) → sensory to scalp/temporal region → no role in eye or pupillary reflex.
Abducent nerve	Innervates lateral rectus muscle → controls eye abduction → no role in pupillary response.

📝 Key takeaway:

RAPD = defect in afferent limb (optic nerve or severe retinal disease)
NOT caused by motor nerve lesions (CN III, IV, VI) or somatic sensory nerves (superficial temporal nerve)

“Think about the type of cartilage that would be best suited for a joint that undergoes both grinding and sliding motions—what is the characteristic of the cartilage that makes it more durable in these conditions?”

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Category: Head and Neck – Anatomy

Why is the temporomandibular joint, a compound condylar variety, called an atypical synovial joint?

It is between temporal bone and mandible

Fibers of lateral pterygoid are attached directly to the articular capsule

It is highly moveable joint

The articular surface is covered by fibrocartilage

It is a highly moveable joint but has no synovial fluid

✅ Correct Answer: The articular surface is covered by fibrocartilage

Let’s first understand what makes the temporomandibular joint (TMJ) atypical compared to most other synovial joints.

TMJ Characteristics:

TMJ is a compound condylar joint:
- The TMJ involves a condylar head of the mandible and the articular eminence of the temporal bone.
- It is compound because it has an articular disc in between these two bones, dividing the joint into two distinct compartments: the upper and lower synovial cavities.
Synovial joint:
- Synovial joints typically have a synovial cavity filled with synovial fluid that facilitates smooth, lubricated movement.
- The joint capsule of the TMJ is lined with synovial membrane, which produces this synovial fluid.

Why D) The articular surface is covered by fibrocartilage is correct:

Fibrocartilage is not typical of most synovial joints, which generally have hyaline cartilage covering the articular surfaces.
In the TMJ, both the mandibular condyle and the temporal bone’s articular surface are covered by fibrocartilage.
This is atypical because fibrocartilage is found more commonly in joints subject to compression forces (like the TMJ) rather than the usual hyaline cartilage seen in joints with more smooth, gliding motions (like the knee or elbow).

❌ Why the other options are incorrect:

Option	Why it’s incorrect
A) It is between the temporal bone and mandible	This is a true statement about the location of the TMJ, but it doesn’t explain why it’s atypical. The fact that it connects these two bones does not make it unusual for a synovial joint.
B) It is a highly moveable joint	While the TMJ is indeed a highly moveable joint, this alone doesn’t make it atypical. Many other synovial joints (like the shoulder and knee) are highly moveable as well, but they are not called atypical. The joint’s structure, rather than its mobility, makes it atypical.
C) Fibers of the lateral pterygoid are attached directly to the articular capsule	This is a true statement—lateral pterygoid does indeed have attachments to the articular disc and capsule. However, this is more about the muscle’s function than the joint being atypical. The attachment of the lateral pterygoid is not what makes the TMJ “atypical” as a synovial joint.
E) It is a highly moveable joint but has no synovial fluid	This is incorrect because the TMJ does have synovial fluid. It is a synovial joint, and the synovial membrane produces fluid to facilitate smooth movement, just like other synovial joints.

📝 Key takeaway:

The TMJ is atypical because it has fibrocartilage covering its articular surfaces instead of the more common hyaline cartilage seen in other synovial joints.
This distinction is important because the TMJ is subjected to different forces (like shear and compressive forces) compared to other joints like the shoulder or hip.

“Consider the function of the sclera—it’s designed for protection and structure, not for light transmission. Think about the parts of the eye that focus or direct light rather than protect it.”

77 / 115

Category: Head and Neck – Anatomy

Light can not pass from which of the following layers of the eye?

lens

Aqueous humor

Sclera

Vitreous humor

pupil

The eye is a complex structure with several layers and components that allow light to travel through and reach the retina, where it is processed. However, light does not pass through all parts of the eye in the same way.

Let’s look at each option closely:

1️⃣ Aqueous humor

The aqueous humor is a transparent, watery fluid located in the anterior chamber (between the cornea and the lens).
Light can pass through the aqueous humor easily as it is transparent, allowing the passage of light to the lens and pupil.

2️⃣ Sclera

The sclera is the white outer layer of the eye that provides structure and protection. It is made of dense connective tissue and is opaque.
Light cannot pass through the sclera because it is a tough, protective layer designed to shield the internal structures of the eye.
The sclera serves to protect the eye and maintain its shape, but it doesn’t participate in the passage of light.

3️⃣ Vitreous humor

The vitreous humor is a transparent, gel-like substance that fills the posterior chamber of the eye (between the lens and retina).
Light can pass through the vitreous humor as well, allowing it to reach the retina, where it is detected by photoreceptor cells.

4️⃣ Lens

The lens is a transparent, flexible structure located behind the iris and the pupil.
Its main role is to focus light onto the retina. Light passes through the lens easily, which helps in bending and focusing the light appropriately.

5️⃣ Pupil

The pupil is the opening in the center of the iris that allows light to pass through into the eye.
It does not obstruct light; in fact, its size adjusts to regulate the amount of light entering the eye.

📝 Key takeaway:

The sclera is opaque and does not allow light to pass through, whereas the other components like the aqueous humor, vitreous humor, lens, and pupil all allow light to pass through in some way to reach the retina.

In this condition, the eye focuses light in front of the retina. What kind of lens would diverge light rays slightly so they hit the retina properly?

78 / 115

Category: Head and Neck – Physiology

Myopia is corrected by what type of lens?

Concave

Mixed

Imaginary

None of these

Convex

Option	Why Incorrect
Convex	Used to correct hyperopia (farsightedness), not myopia.
None of these	One is clearly correct—concave.
Imaginary	Not a lens type in optics.
Mixed	Vague and not an actual category of lens used in correction.

This taste is often described as savory or meaty—think about broth, aged cheese, and soy sauce. What common molecule in protein-rich foods activates this flavor?

79 / 115

Category: Head and Neck – Physiology

Umami taste fibers are related to?

Glutamate

Organic substances containing nitrogen

Alkaloids

Acetic acid

Fructose

Option	Why Incorrect
Organic substances with nitrogen	Too vague. Could include proteins, but not specific to umami.
Fructose	Sweet taste receptor activator, not umami.
Alkaloids	Often bitter (e.g., caffeine, morphine).
Acetic acid	Responsible for sour taste.

Aphakia means absence of the lens—what happens to a person’s ability to focus light when the eye’s primary refractive structure is missing?

80 / 115

Category: Head and Neck – Physiology

Aphakia is associated with which of the following?

Astigmatism

Hypermetropia

Hyphema

Pseudoaphakia

Glaucoma

Option	Why Incorrect
Glaucoma	Increased intraocular pressure, unrelated to lens absence
Pseudoaphakia	Condition after lens removal with IOL implanted—not aphakia
Astigmatism	Due to irregular curvature of cornea/lens, not total absence
Hyphema	Blood in the anterior chamber—related to trauma, not lens loss

This molecular combo is like the light switch of your visual world — flip it with a photon, and it launches a cascade that lets your brain form images. So what do we call this photoreceptor-bound duo?

81 / 115

Category: Head and Neck – Biochemistry

11-cis retinal bound to a specific protein is classified as which of the following?

Intermediates

Retinoid acid binding protein

None of these

Photo-transducer

Visual pigment

In a world of pixels, where would nature put its highest resolution camera? Not the frame or the screen — but a tiny focused dot within a broader field.

82 / 115

Category: Head and Neck – Physiology

Which of the following is the most sensitive part of the eye?

Fovea

Macula

Retina

None of these

Choroid

Imagine a piano string — the thicker and looser it is, the deeper the sound it makes. Now ask yourself: where in the spiral of sound does the most relaxed membrane live?

83 / 115

Category: Head and Neck – Physiology

A person can not listen to low pitch sounds. Which of the following regions is involved?

None of these

Round window

Helicotrema

Oval window

Cochlear base

When your surroundings get muffled, but your bones still hum, which direction does your brain think the sound is coming from?

84 / 115

Category: Head and Neck – Physiology

A patient has conductive deafness in the left ear. Which of the following findings will help us know this?

Positive Rinne's test in right ear

Weber's lateralized to left ear

Positive Rinne's test in left ear

None of these

Weber's lateralized to right ear

When both highways (air and bone) are open, the brain listens equally. But if one road goes quiet due to a broken engine, which direction will your brain turn to follow the music?

85 / 115

Category: Head and Neck – Physiology

A patient has sensorineural deafness in the right ear. A ‘tuning fork’ test will indicate which of the following?

None of these

Weber's lateralized to right ear

Weber's lateralized to left ear

Negative Rinne's test in left ear

Positive Rinne's test in right ear

Ask yourself: where does nature face its sharpest transition — from the outside world to the inner machinery? Where is the sudden change the most abrupt when a beam first enters the gateway to vision?

86 / 115

Category: Head and Neck – Physiology

The greatest difference of refractive indices is found at which of the following sites?

Between aqueous humor and the anterior surface of lens

Between posterior surface of cornea and aqueous humor

Between air and anterior surface of cornea

None of these

Between the posterior surface of lens and vitreous humor

“Think about where the hearing problem originates—is it a mechanical blockage or an issue with sound processing? Which type would benefit most from simply making sounds louder?”

87 / 115

Category: Head and Neck – Physiology

A hearing aid is most useful in which of the following hearing problems?

Sensorineural loss

Conductive deafness

Noise-mediated hearing loss

Presbycusis

Perceptive deafness

When the microphone works, and the wire to the brain is intact, but the speaker inside the ear is broken, you don’t fix the speaker—you bypass it with direct signals.

88 / 115

Category: Head and Neck – Physiology

Cochlear implants are used as a treatment for which type of deafness?

Otosclerosis

None of these

Vestibulocochlear nerve lesion

Sensorineural loss

Conductive deafness

Think of each eye as a camera with its own cable. If you cut the cable before it sends anything to the brain, what happens to that eye’s vision—even if the brain is working perfectly?

89 / 115

Category: Head and Neck – Physiology

Damage to the right optic nerve will lead to which of the following?

Right homonymous hemianopia

Left homonymous hemianopia

Bitemporal hemianopia

Total blindness in right eye

Total blindness in left eye

If a train track carries only left-facing windows, and that track is cut, think about which sides of the world both passengers can no longer see.

90 / 115

Category: Head and Neck – Physiology

Damage to the right optic tract causes a defect in which field of vision?

Contralateral nasal and contralateral temporal fields

Ipsilateral nasal and ipsilateral temporal fields

None of these

Ipsilateral nasal and contralateral temporal fields

Ipsilateral temporal and contralateral nasal fields

👁️‍🗨️ Step 1: Understanding the Visual Pathway

Each eye captures visual information from both left and right visual fields:

The nasal retina sees the temporal (lateral) field of vision.
The temporal retina sees the nasal (medial) field of vision.

Now here’s how the fibers travel:

Fibers from the nasal retina cross over at the optic chiasma.
Fibers from the temporal retina do not cross; they stay on the same side.

This means:

The right optic tract carries:
- Left visual field of both eyes:
  - From the left nasal retina (crossed fibers from left eye)
  - From the right temporal retina (uncrossed fibers from right eye)

🎯 Step 2: Lesion of the Right Optic Tract

If the right optic tract is damaged, you lose:

The left visual field from both eyes:
- Left temporal field of the left eye (seen by nasal retina)
- Left nasal field of the right eye (seen by temporal retina)

So the defect is:

Left (contralateral) homonymous hemianopia
That is:
Left temporal field (seen by right nasal retina — fibers crossed)
Left nasal field (seen by right temporal retina — fibers uncrossed)

✅ So, the correct match is:

Ipsilateral nasal (right eye) and contralateral temporal (left eye) fields

Why?

Ipsilateral = right eye = nasal field lost (temporal retina)
Contralateral = left eye = temporal field lost (nasal retina)

❌ Why the Other Options Are Incorrect:

❌ Ipsilateral temporal and contralateral nasal fields

That would be bitemporal hemianopia, caused by optic chiasma lesion.

❌ Ipsilateral nasal and ipsilateral temporal fields

That would imply monocular (one-eye) total field loss — seen in optic nerve damage, not tract.

❌ Contralateral nasal and contralateral temporal fields

This would be complete visual loss in the opposite eye, not possible from a unilateral tract lesion.

❌ None of these

Incorrect because one of the given options (ipsilateral nasal and contralateral temporal fields) is correct.

“Think about the action that directly blocks the opening to the windpipe during swallowing, ensuring food goes down the right way.”

91 / 115

Category: Head and Neck – Physiology

Which of the following is the most important process in swallowing that prevents the entry of food into the larynx?

Upward movement of pharynx

Opening of epiglottis

Closure of vocal cords

Forward movement of larynx

Upward movement of uvula

Swallowing is a complex process that involves a series of coordinated actions to ensure that food or liquid enters the esophagus and not the airway. The key goal during swallowing is to protect the larynx (the airway) from food or liquids that might cause choking or aspiration.

Correct Answer: Closure of vocal cords

The closure of the vocal cords (also known as the glottic closure) is the most crucial mechanism that prevents food from entering the larynx during swallowing.
During swallowing, the vocal cords tightly close, preventing any food or liquid from entering the trachea (windpipe). This is vital for airway protection, as the vocal cords create a barrier between the digestive and respiratory tracts.

Why the Other Options Are Incorrect:

Upward movement of uvula
- The uvula moves upward to help seal the nasopharynx and prevent food from entering the nasal cavity. While this is an important action for nasal protection, it does not directly prevent food from entering the larynx.
- Therefore, this option is incorrect.
Forward movement of larynx
- The forward movement of the larynx during swallowing aids in the protection of the airway by bringing the larynx closer to the epiglottis, helping with the closing of the airway. However, this movement alone does not prevent food from entering the larynx.
- Therefore, this option is incorrect.
Upward movement of pharynx
- The upward movement of the pharynx during swallowing helps propel the food bolus toward the esophagus, but it does not directly prevent food from entering the larynx. This movement is part of the overall process of moving food down into the esophagus.
- Therefore, this option is incorrect.
Opening of epiglottis
- The epiglottis actually closes over the larynx to protect it from food during swallowing. If the epiglottis were to open during swallowing, food could easily enter the airway. So, the epiglottis must close to protect the larynx, not open.
- Therefore, this option is incorrect.

Key Takeaways:

The closure of the vocal cords is the most important mechanism that prevents food from entering the larynx during swallowing. It provides a direct barrier between the digestive and respiratory tracts.
Other actions, such as the upward movement of the uvula or forward movement of the larynx, are involved in protecting other parts of the airway but are not the most critical for preventing food from entering the larynx.

“Consider which phase involves conscious effort in moving food from the mouth to the throat, and think about which phases happen automatically after that.”

92 / 115

Category: Head and Neck – Physiology

Which of the following is a voluntary phase of swallowing?

Intestinal phase

Esophageal phase

Oral phase

Pharyngeal phase

Saliva secretion

Swallowing, or deglutition, is a complex process that involves multiple phases. These phases can be broadly categorized into voluntary and involuntary stages, depending on the level of conscious control exerted over them. Let’s break down each phase:

Correct Answer: Oral phase

The oral phase of swallowing is the voluntary phase where the food is consciously manipulated in the mouth to form a bolus (a small mass of chewed food).
During this phase, the tongue pushes the bolus toward the back of the mouth, and the person has full conscious control over this action. It is the first stage of swallowing, and it ends when the bolus reaches the pharynx.

Why the Other Options Are Incorrect:

Intestinal phase
- The intestinal phase of digestion refers to the phase after food has entered the small intestine. It is an involuntary process, controlled by hormonal and neural mechanisms, and is not a part of swallowing itself.
- Therefore, this option is incorrect.
Saliva secretion
- Saliva secretion is an autonomic (involuntary) process primarily controlled by the parasympathetic nervous system. While saliva is essential for swallowing, its production is not considered a voluntary phase of swallowing.
- Therefore, this option is incorrect.
Pharyngeal phase
- The pharyngeal phase of swallowing is involuntary and involves the reflex action of food moving from the mouth to the esophagus. It is a rapid, reflexive process controlled by the medulla oblongata and does not require conscious control.
- Therefore, this option is incorrect.
Esophageal phase
- The esophageal phase is the final part of the swallowing process, which involves the involuntary movement of food through the esophagus to the stomach. It is primarily controlled by peristalsis and the autonomic nervous system.
- Therefore, this option is incorrect.

Key Takeaways:

The oral phase is the only voluntary phase of swallowing, where you consciously control the movement of the food bolus in the mouth.
The pharyngeal and esophageal phases are involuntary and involve reflexes controlled by the autonomic nervous system.

“Think about which tastes are associated with ions that can dissociate in water and how the tongue detects those specific ions to produce a taste sensation.”

93 / 115

Category: Head and Neck – Physiology

A few students while conducting research found that some areas of the tongue are stimulated when they get in touch with ionized molecules. Which of the following taste sensations will be produced by these ionized molecules?

Bitter and sweet

Sweet and umami

Salty and sweet

Salty and umami

Salty and sour

Taste sensations are detected through specific receptors on the tongue that respond to different types of molecules. The sensation of taste is categorized into five primary tastes: salty, sweet, sour, bitter, and umami. The nature of the molecule, particularly its ionic composition, plays a crucial role in how the taste is perceived.

Correct Answer: Salty and sour

Salty taste is primarily caused by ionized molecules, especially sodium ions (Na⁺). When salt (like NaCl) dissociates in the mouth, the sodium ions are detected by specific receptors on the taste buds.
Sour taste is primarily caused by the presence of acidic ions, such as hydrogen ions (H⁺). When acidic substances like citric acid or vinegar dissolve, the hydrogen ions interact with the taste receptors to produce the sour taste.

Both salty and sour tastes are directly related to the detection of ionized molecules, and this makes them the correct answer.

Why the Other Options Are Incorrect:

Salty and umami
- Umami is the taste associated with glutamate and other amino acids, particularly in protein-rich foods. This taste is not primarily driven by ionized molecules but by the binding of specific molecules to receptors.
- Therefore, this option is incorrect.
Salty and sweet
- Sweet taste is typically triggered by molecules like sugars (e.g., glucose, fructose) and is not related to ionized molecules in the same way as salty and sour tastes are. Sweetness results from molecular interaction, not ionization.
- Therefore, this option is incorrect.
Bitter and sweet
- Bitter taste is caused by a wide variety of compounds, often complex molecules that do not involve ionized substances in the same way. Like sweet, it is not primarily associated with ionization.
- Therefore, this option is incorrect.
Sweet and umami
- Both sweet and umami are based on molecular interactions with receptors rather than on ionized molecules, making this combination an incorrect choice for this question.
- Therefore, this option is incorrect.

Key Takeaways:

Salty and sour tastes are both related to the detection of ionized molecules—sodium ions for salty and hydrogen ions for sour.
Other taste sensations like sweet and umami are based on the interaction of larger, non-ionic molecules with specific taste receptors.

“Think about how a wave of muscle contractions travels through the digestive tract to propel food forward. Which muscles need to contract and which need to relax as the food moves down?”

94 / 115

Category: GIT – Physiology

Which of the following correctly describes the function of the myenteric plexus in causing the peristaltic movements of the gut?

Inhibiting circular muscle below the bolus

Stimulating circular muscles above the bolus

Inhibiting longitudinal muscles below the bolus

Inhibiting circular muscle above the bolus

Inhibiting vagus nerve

The myenteric plexus (also known as Auerbach’s plexus) is a critical part of the enteric nervous system that plays a vital role in the regulation of gastrointestinal motility, specifically peristalsis. Peristalsis is the wave-like contraction and relaxation of muscles that propel food (or a bolus) through the digestive tract.

The myenteric plexus is located between the circular and longitudinal muscle layers of the gut wall. It coordinates muscle contraction and relaxation to produce the peristaltic wave that moves food along the gut.

Let’s analyze each option in the context of how the myenteric plexus coordinates these movements:

Correct Answer: Stimulating circular muscles above the bolus

During peristalsis, the myenteric plexus plays an important role by regulating muscle activity in response to the movement of the food bolus.
- The circular muscles above the bolus contract to push the bolus forward, while the longitudinal muscles below the bolus relax to allow the gut to lengthen and accommodate the bolus.
- The myenteric plexus stimulates the circular muscles above the bolus to contract, which pushes the bolus down the digestive tract.
- It also inhibits the circular muscles below the bolus and stimulates the longitudinal muscles below the bolus to relax, enabling the bolus to move smoothly.

Thus, the correct function of the myenteric plexus in peristalsis is to stimulate the circular muscles above the bolus to help move the bolus forward.

Why the Other Options Are Incorrect:

Inhibiting circular muscle below the bolus
- The myenteric plexus does indeed inhibit the circular muscles below the bolus, but this inhibition is not the main function driving peristalsis. Instead, the key role is stimulating circular muscles above the bolus to move it forward, while inhibiting below the bolus is a secondary action that allows the bolus to move smoothly.
- Therefore, Option 1 is partially correct, but it doesn’t describe the primary function.
Inhibiting longitudinal muscles below the bolus
- The longitudinal muscles below the bolus are actually stimulated by the myenteric plexus, not inhibited, to allow the gut to lengthen and accommodate the bolus. Inhibition of longitudinal muscles below the bolus would hinder the normal movement of the bolus through the gut.
- Therefore, Option 3 is incorrect.
Inhibiting vagus nerve
- The vagus nerve is part of the autonomic nervous system and helps regulate the enteric nervous system, but its inhibition is not a function of the myenteric plexus. The myenteric plexus primarily functions in local control of gut motility, and its effects on peristalsis do not directly involve the inhibition of the vagus nerve.
- Therefore, Option 4 is incorrect.
Inhibiting circular muscle above the bolus
- The circular muscles above the bolus must contract to help propel the bolus forward, not inhibit. Inhibition of the circular muscles above the bolus would prevent peristalsis from occurring properly.
- Therefore, Option 5 is incorrect.

Key Takeaways:

The myenteric plexus is responsible for the coordination of peristaltic movements in the gut by stimulating the circular muscles above the bolus to contract and help move the bolus forward.
The myenteric plexus also relaxes the longitudinal muscles below the bolus and inhibits the circular muscles below the bolus to aid in the movement of the bolus.
Peristalsis requires a coordinated effort of muscle contraction and relaxation, and the myenteric plexus is the main regulator of this process.

“Think about which structures are involved in transforming mechanical sound vibrations into electrical signals that the brain can interpret as sound.”

95 / 115

Category: Head and Neck – Physiology

A soldier lost his sense of hearing due to exposure to loud sounds. Damage to which of the following organs can result in hearing loss?

Utricle

Inner hair cells

Vestibule

Saccule

Cochlea

✅ Correct Answer: Inner hair cells

🔍 Understanding the auditory system:

The ear is divided into three parts:

Outer ear: Collects sound waves (pinna and ear canal)
Middle ear: Contains the ossicles (malleus, incus, stapes) that transmit sound vibrations to the inner ear
Inner ear: Contains the cochlea, semicircular canals, vestibule, and structures responsible for both hearing and balance.

🦻 Hearing and the cochlea:

The cochlea is the primary organ for hearing, located in the inner ear.
It contains the Organ of Corti, which houses the hair cells (both inner and outer).
- Inner hair cells are responsible for converting sound vibrations into electrical signals that are sent to the brain via the auditory nerve.
- Outer hair cells amplify sound vibrations but are not primarily responsible for the actual detection of sound.

What happens with loud sound exposure?

Loud sounds (like those from gunfire or explosions) can cause damage to the inner hair cells of the cochlea.
Inner hair cells are particularly vulnerable to damage from excessive noise because they have a limited ability to regenerate.
Once these cells are damaged or destroyed, the individual experiences sensorineural hearing loss, which is often permanent.

🦴 Why the other options are incorrect:

A) Cochlea:
- While the cochlea houses the inner hair cells, it is the damage to inner hair cells specifically that leads to hearing loss. The cochlea itself is an organ, but damage to the inner hair cells within it is the main cause.
  ❌ Incorrect, but related.
C) Saccule:
- The saccule is part of the vestibular system in the inner ear and is involved in detecting vertical linear acceleration (balance), not hearing.
  ❌ Incorrect.
D) Utricle:
- Similar to the saccule, the utricle is part of the vestibular system and detects horizontal linear acceleration.
- It has no direct role in hearing.
  ❌ Incorrect.
E) Vestibule:
- The vestibule, which contains both the saccule and utricle, is part of the balance system and not involved in the detection of sound.
  ❌ Incorrect.

📝 Key takeaway:

→ Damage to the inner hair cells of the cochlea due to loud sounds can cause sensorineural hearing loss, which is typically permanent.

“Think about where sensory modalities, like taste, might be integrated with other sensory experiences, such as touch or smell, to create a richer perception.”

96 / 115

Category: Head and Neck – Physiology

Third-order neurons of the taste pathway terminate at which of the following areas of the brain?

Broadman's area 6

Broadman's area 22

Broca's area

Opercular insular area

Broadman's area 17

✅ Correct Answer: Opercular insular area

🔍 The taste pathway (gustatory pathway):

The taste sensation is processed through several stages:

First-order neurons:
- Taste receptors on the tongue, soft palate, and pharynx detect taste stimuli.
- These signals are carried by cranial nerves:
  - Facial nerve (CN VII): Anterior two-thirds of the tongue
  - Glossopharyngeal nerve (CN IX): Posterior one-third of the tongue
  - Vagus nerve (CN X): Pharynx and epiglottis
Second-order neurons:
- The nucleus of the solitary tract (NST) in the brainstem receives input from the first-order neurons.
- These second-order neurons then cross to the contralateral side of the brainstem and ascend to the thalamus (specifically, the ventral posteromedial nucleus (VPM)).
Third-order neurons:
- The third-order neurons originate in the thalamus (VPM nucleus) and project to the gustatory cortex.
- The gustatory cortex is located in the opercular insular area (part of the insular cortex and adjacent operculum of the frontal lobe), which is responsible for the conscious perception of taste.

🧠 Where do these third-order neurons terminate?

The opercular insular area (part of the insula and the parietal operculum) is the primary area for taste processing.
This area, located near the somatosensory cortex, integrates information related to taste and combines it with other sensory inputs for multisensory perception.

🧐 Why the other options are incorrect:

A) Broadman’s area 6:
- Area 6 is related to motor control (pre-motor cortex, involved in planning movement).
  ❌ Incorrect.
B) Broadman’s area 22:
- Area 22 is associated with language processing (Wernicke’s area).
  ❌ Incorrect.
C) Broca’s area:
- Located in the frontal lobe, this area is involved in speech production, not taste.
  ❌ Incorrect.
E) Broadman’s area 17:
- Area 17 is the primary visual cortex (responsible for processing visual stimuli).
  ❌ Incorrect.

📝 Key takeaway:

→ Third-order neurons of the taste pathway terminate at the opercular insular area, which is part of the insula and involved in processing taste sensations.

“Consider which part of the inner ear is arranged in three perpendicular planes to monitor head movement in all directions.”

97 / 115

Category: Head and Neck – Physiology

Which of the following contains receptors to detect centrifugal acceleration in order to determine angular acceleration?

Vestibule

Semicircular canals

Utricle

Cochlea

Saccule

✅ Correct Answer: Semicircular canals

🔍 Understanding acceleration detection in the inner ear:

The inner ear has two primary sensory systems:

Cochlea → hearing
Vestibular apparatus → balance and spatial orientation

The vestibular apparatus includes:

Semicircular canals (3)
Utricle
Saccule

Each structure has specialized receptors for detecting different types of movement.

🧭 What is angular (rotational) acceleration?

Angular acceleration refers to rotation of the head (e.g., turning your head side to side, spinning). It involves detecting changes in speed of rotation around an axis.

To detect this, the body uses receptors sensitive to rotational or angular movements—this is different from detecting linear (straight-line) acceleration.

✅ The semicircular canals (anterior, posterior, lateral) are specialized to detect angular acceleration in three planes (like the x, y, z axes).

They do this via:

Crista ampullaris: sensory epithelium inside an enlarged area at the base of each canal (ampulla)
The crista contains hair cells that respond to movement of endolymph (fluid) as the head rotates
Movement of endolymph bends the hair cells → sends signals to the brain about head rotation

🧐 Why the other options are incorrect:

A) Cochlea:
- Contains the organ of Corti for hearing, not balance
  ❌ Incorrect.
B) Vestibule:
- General term referring to the central part of the bony labyrinth
- Contains utricle and saccule but itself doesn’t directly house angular acceleration receptors
  ❌ Incorrect.
C) Saccule:
- Detects linear acceleration in the vertical plane (e.g., moving in an elevator)
  ❌ Incorrect.
D) Utricle:
- Detects linear acceleration in the horizontal plane (e.g., driving forward or backward)
  ❌ Incorrect.

📝 Key takeaway:

→ Angular (rotational) acceleration is detected by the semicircular canals via the crista ampullaris within the ampullae.

Imagine a hammock-like sling supporting the globe of the eye from below, stabilizing it during movement. Which fibrous sheath surrounds the eyeball and helps form this “hammock”?

98 / 115

Category: Head and Neck – Histology

The suspensory ligaments of the eye are an extension of which of the following?

Orbital septum

Periorbital fascia

Tenon's capsule

Deep fascia

Superficial fascia

Structure	Why Incorrect
Orbital septum	Anterior extension of periosteum; separates eyelid from orbit. Not involved in suspending the globe.
Deep fascia	Non-specific term; not directly related to the eyeball fascia.
Periorbital fascia	Refers to periorbita—periosteum lining the orbit, not Tenon’s capsule.
Superficial fascia	Subcutaneous tissue; not relevant to deep orbital support.

Taste buds are located on papillae responsible for gustatory sensation, but not all papillae are for taste—some are for friction or texture. Which one is all about grip, not flavor?

99 / 115

Category: Head and Neck – Histology

Taste buds are present in the following papillae except:

Fungiform

Foliate

Filliform

Circumvalate

Fulliform

Papilla Type	Taste Buds Present?	Location & Role
Circumvallate	✅ Yes	Located at the back of the tongue; contain many taste buds in crypts.
Foliate	✅ Yes	Found on the lateral margins of the tongue; especially active in children.
Fungiform	✅ Yes	Scattered over the anterior 2/3; fewer taste buds, but easily visible.

Oblique facial clefts run from the upper lip to the medial corner of the eye. Which fusion failure would result in an open groove—leaving a visible slit along the cheek?

100 / 115

Category: Head and Neck – Embryology

An oblique facial cleft is a developmental anomaly that occurs due to failure of fusion of which of the following structures?

Two mandibular prominence with each other

Maxillary prominence with medial nasal prominence

Maxillary prominence with lateral nasal prominence

Two medial nasal prominence with each other

Two maxillary prominence with each other

Keratomalacia is not an early sign of vitamin A deficiency. It’s a destructive, advanced stage that affects the integrity of the cornea. Which option reflects structural damage and loss of transparency, not just early symptoms?

101 / 115

Category: Head and Neck – Biochemistry

In the case of vitamin A deficiency, keratomalacia occurs. Which of the following characterizes this condition?

Patient cannot see in low light or in near dark condition

Dryness and clouding of cornea

Dryness of conjunctiva and cornea

Unable to see in light or dark condition

Localized thickening of conjunctiva

When a camera is being built, consider: what forms the light-absorbing layer—its black matte lining—from the outer shell, not the wiring inside?

102 / 115

Category: Head and Neck – Embryology

Which of the following gives rise to the pigment epithelium layer of an eye?

Outer layer of optic cup

Pars ceca retinae

Pars iris

Pars ciliaris retinae

Inner layer of optic cup

If you needed a communication line between your outer sensor and internal analyzer—would you carve a channel, a tube, or both? Consider where pressure regulation and vibration meet.

103 / 115

Category: Head and Neck – Embryology

Which of the following structures gives rise to the air-filled cavity present in the petrous part of the temporal bone?

Second pharyngeal pouch

Fifth pharyngeal pouch

Fourth pharyngeal pouch

First pharyngeal pouch

Third pharyngeal pouch

Imagine you’re designing a system to constantly “rinse and reset” a sensor to detect new signals without interference. Would you use something that sticks—or something that clears?

104 / 115

Category: Head and Neck – Histology

Which of the following types of secretions are released into the troughs of circumvallate papillae?

Entirely serous from Von Ebner's gland

Seromucous

Predominantly mucous from parotid gland

Entirely mucous from gustatory glands

Predominantly serous from parotid gland

“Think about how the middle ear bones develop—are they all from the same embryonic structure, or do they have different origins?”

105 / 115

Category: Head and Neck – Embryology

Which of the following is true regarding the tympanic membrane?

It consists of 2 layers

Pars flaccida is the area between the umbo of malleus and the posterior malleolar fold

Malleus and incus are derived from first pharyngeal arch during embryogenesis

Footplate of stapes attaches to it

None of these

If the first arch builds the foundation for chewing and speaking, what tiny hammer-shaped bone must it forge to help transmit the first sounds of life?

106 / 115

Category: Head and Neck – Embryology

Which of the following structures is derived from the 1st pharyngeal arch?

Buccinator

None of these

Malleus

Stylohyoid

Greater cornu of hyoid bone

If the central beauty mark of the upper lip is the philtrum, which two symmetrical forces must first come together to sketch its groove?

107 / 115

Category: Head and Neck – Embryology

The intermaxillary segment is formed by fusion of which of the following?

Medial and lateral nasal prominences

Maxillary and nasal prominences

Two lateral nasal prominences

None of these

Two medial nasal prominences

If the eyes are the windows to the brain, ask yourself: from which inner room of the forebrain do those windows first begin to bulge outward?

108 / 115

Category: Head and Neck – Embryology

Optic vesicles are out pocketings formed by which of the following structures?

Prosencephalon

Mesencephalon

Diencephalon

Telencephalon

Rhombencephalon

Which part of the eye acts like a growing onion — adding layer after layer silently each year, until it starts to stiffen and blur the close-up world?

109 / 115

Category: Head and Neck – Embryology

Which part of the eye continues to grow throughout the lifetime?

Lens

Cornea

Iris

Choroid

Retina

If you think of your eyelashes like tiny bristles, which gland would act like the oiling agent — preventing them from drying out or breaking off?

110 / 115

Category: Head and Neck – Histology

Which type of gland is the gland of Zeis?

Modified sweat glands

Mebomian glands

Mucus glands

Modified lacrimal glands

Modified sebaceous glands

When light dims and dryness takes over the eyes, think of the nutrient that’s not just about vision but about keeping barriers hydrated and protective.

111 / 115

Category: Head and Neck – Biochemistry

Which of the following diseases is caused by the deficiency of vitamin A?

Megaloblastic anemia

Hair loss

Hemorrhage

Xerophthalmia

Exophthalmos

“Think about which form of vitamin A is directly absorbable into the intestinal lymphatics and what must be removed from the ester before absorption.”

112 / 115

Category: Head and Neck – Biochemistry

Which of the following are the end products of hydrolysis of retinyl esters in intestinal mucosa?

Retinoic acid and retinol

Retinal and retinol

Retinoic acid and free fatty acids

Retinol and free fatty acids

Retinal and free fatty acids

Think about the different roles played by various parts of the tongue—some need more protection from mechanical stress, while others need to remain more sensitive for sensory input. How might these functional differences affect the way the surface is built?

113 / 115

Category: Head and Neck – Histology

Dorsum of the tongue is lined by which epithelium?

Stratified squamous non-keratinized

Stratified squamous keratinized

Stratified squamous partially keratinized

Stratified columnar

Pseudostratified columnar

To appreciate the epithelium covering the dorsum of the tongue, let’s examine both function and regional variation in epithelial types.

🧬 1. Structure and function of the dorsum:

The dorsum (top surface) of the tongue is exposed to constant mechanical stress—friction, food movement, temperature, and microbial exposure.
To withstand this, it is covered by stratified squamous epithelium, which is multilayered for protection.

🌟 2. Keratinization—complete or partial?

The dorsum is not uniformly keratinized.
It is partially keratinized, meaning:
- Some regions (especially those with filiform papillae, primarily in the anterior dorsum) are keratinized.
- Other regions (especially near the posterior third, which includes taste buds and lingual tonsils) are non-keratinized or less keratinized.
This transitional pattern allows both protection and sensitivity—important for both mechanical and sensory roles.

❌ Why the Other Options Are Incorrect:

1. Pseudostratified columnar:

Found in the respiratory tract, not in the tongue.
This type includes cilia and goblet cells, which are unnecessary for the tongue’s abrasive surface.

2. Stratified columnar:

Rare and found in parts of the conjunctiva, pharynx, or male urethra.
Not suited for high-friction environments like the tongue.

3. Stratified squamous non-keratinized:

Found in moist, protected surfaces like the oral cavity lining, esophagus, and vagina.
Parts of the ventral tongue (underside) use this, but not the dorsum.

4. Stratified squamous keratinized:

Partially true, as parts of the anterior dorsum are fully keratinized.
However, this does not represent the entire dorsum, especially the posterior third, which lacks full keratinization.
Therefore, “partially keratinized” more accurately describes the overall epithelial composition.

Laiq Hussain Page 182

“Which form of vitamin A is chemically altered when light strikes the photoreceptors in the retina, leading to the signal that allows you to see?”

114 / 115

Category: Head and Neck – Biochemistry

Which of the following is an active metabolite of vitamin A present in the eye?

Carotenoid

Retinal

Retinoic acid

Beta carotene

Retinol

“Think about the function of the very front of the tongue—it needs to help with both lubrication and enzymatic breakdown. What type of gland can meet both demands?”

115 / 115

Category: Head and Neck – Histology

Which type of secretion is produced by the glands at the tip of the tongue?

Seromucous

Purely serous

gel like secretions

Watery secretions

Purely mucous

Tongue region	Type of gland	Secretion type
Tip (apex)	Anterior lingual glands (glands of Blandin and Nuhn)	Seromucous
Posterior (root)	Posterior lingual glands (glands of Weber)	Mucous
Around circumvallate papillae	Von Ebner’s glands	Purely serous

Option	Why it’s incorrect
Purely mucous	Posterior glands (like Weber’s) produce mucous; glands at the tip produce both types, not purely mucous.
Gel-like secretions	Descriptive term, but histologically corresponds to mucous secretion → again, the tip has mixed secretion, not purely mucous/gel-like.
Purely serous	Von Ebner’s glands (near circumvallate papillae) produce pure serous; not the tip of the tongue.
Watery secretions	Describes serous secretion; glands at the tip are mixed, so not purely watery.

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Head And Neck – 2021

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Correct Answer: Tensor veli palatini

Why the Other Options Are Incorrect:

Key Takeaways:

Correct Answer: Levator palpebrae superioris

Why the Other Options Are Incorrect:

Key Takeaways:

Correct Answer: Cones

Why the Other Options Are Incorrect:

Key Takeaways:

✅ Correct Option: Descending palatine

❌ Incorrect Options:

1. Sphenopalatine artery

2. Anterior ethmoidal artery

3. Posterior ethmoidal artery

4. Lateral nasal artery

1. Clinical Clue:

🧠 Lymphatic Drainage of the Lower Lip:

❌ Why the other options are incorrect:

🌟 Pupillary Reflex Pathway Overview:

❌ Why the Other Options Are Incorrect:

🎯 Accommodation for Near Vision — What Happens?

🧬 Mechanism:

❌ Why the Other Options Are Incorrect:

🧱 Bones that form the floor of the temporal fossa:

❌ Why the Incorrect Options are Affected:

🧠 Why the Lesser Wing of Sphenoid is NOT Affected:

✅ Why “Lingual nerve” is correct:

❌ Why the other options are incorrect:

1. Inferior alveolar nerve

2. Submental nerve

3. Glossopharyngeal nerve (CN IX)

4. Auriculotemporal nerve

❌ Why the Other Options Are Incorrect:

1. Fracture of sphenoid body

2. Fracture of nasal bone

3. Fracture of zygomatic arch

4. None of these

“It divides into internal and external carotid artery at the upper border of thyroid cartilage”

❌ Incorrect Options and Why:

❌ “It supplies a branch to the thyroid gland”

❌ “It has a dilatation on it just after its initiation below the bifurcation”

❌ “At the left side, common carotid artery arises from the brachiocephalic trunk”

❌ “At the right side, common carotid artery arises from the arch of aorta”

❌ Why the other options are contents:

✅ Pterygopalatine ganglion

✅ Nerve to pterygoid canal (Vidian nerve)

✅ Zygomatic nerve

❌ None of these

❌ Why the Other Options Are Affected:

1. Stapedius

2. Occipito-frontalis

3. Taste from anterior 2/3 of the tongue

4. Buccinator

✅ Correct Answer Explained:

“Pupillary dilatation and abduction of eye”

❌ Why Other Options Are Incorrect:

❌ Pupillary constriction and adduction of eye

❌ Pupillary constriction and abduction of eye

❌ Pupillary dilatation and adduction of eye

❌ None of these

✅ Why Fourth cranial nerve is correct:

❌ Why the Other Options Are Incorrect:

❌ Sixth (Abducens nerve)

❌ Third (Oculomotor nerve)

❌ Fifth (Trigeminal nerve)

❌ None of these

1. ✅ Basilar membrane

2. ❌ Cupula

3. ❌ None of these

4. ❌ Tectorial membrane

5. ❌ Otolithic membrane

✅ Facial

❌ Vagus

❌ Hypoglossal

❌ Trigeminal

❌ Glossopharyngeal

✅ Pterygopalatine ganglion

❌ Otic ganglion

❌ **Why the Incorrect Options are Affected:**