Answers to multiple-choice & matching questions Practice final exam for Head & Neck anatomy – 2008 1. D 2. C 3. E 4. E 5. D 6. E 7. C 8. A 9. D 10. E 11. A 12. B 13. D 14. A 15. C 16. B 17. A 18. E 19. E 20. D 21. B 22. C 23. C 24. A 25. B 26. E 27. D 28. D 29. C 30. C 31. D 32. D 33. D 34. A 35. C 36. B 37. A 38. E 39. B 40. A 41. E 42. A 43. D 44. B 45. Any four of these areas: Posterior lateral wall of nasal cavity, posterior nasal septum, soft palate, hard palate, superior part of nasopharynx . REASON: all these areas are supplied by sensory branches of V2 that pass through or near the PP ganglion. A PP ganglion block affects these nerves. 46. This area of the posterior triangle is known as the subclavian triangle because it contains the third part of the subclavian artery. Downward pressure in this area compresses the subclavian artery against the first rib, thus restricting or eliminating blood flow to the upper limb. Moral of the story: Don’t cycle if you don’t know head and neck anatomy. 47. A. Oblique arytenoid muscle or aryepiglottic muscle. B. Cricothyroid muscle. C. Posterior cricoarytenoid muscle. 48. The submandibular duct leaves the deep portion of the submandibular gland and courses antero-medially in the submandibular triangle toward the floor of the oral cavity. Along the way, it passes external to the hyoglossus muscle then deep to the mylohyoid muscle. As it crosses the hyoglossus it is closely related to the lingual nerve – in fact – the two twist around each other. There is a funny saying in old anatomy books that goes like this: “The lingual nerve took a swerve across the hyoglossus .. I’ll be plucked (or whatever) said Wharton’s duct, the bloke has double-crossed us!” I know it’s stupid .. but I remember it.. and it describes the fact that the lingual nerve and submandibular duct twist around each other – thus the lingual crosses over the duct twice. Oh .. btw .. the submandibular duct passes between the sublingual gland and genioglossus muscle and opens in the floor of the oral cavity below the tongue on the summit of the sublingual fold at the sublingual caruncle (a little papilla that marks the orifice of the duct), just lateral to the lingual frenulum. 49. Lesser occipital nerve = to posterior inferior scalp and medial surface of auricle. Great auricular nerve = to skin over parotid gland and external surface of auricle. Transverse cervical nerve = to skin of anterior and lateral neck. Supraclavicular nerves = to skin over trapezius, summit of shoulder, and skin over clavicle. 50. Cell bodies of post-synaptic neurons are in the superior cervical ganglion of sympathetic trunk carotid nerves internal carotid plexus [carotid canal] deep petrosal nerve [enter pterygoid canal] nerve of pterygoid canal [leave pterygoid canal] [enter pterygopalatine fossa] pass through pterygopalatine ganglion join nasopalatine nerve (of V2) [sphenopalatine foramen] nasal septum supply smooth of blood vessels (action = vasoconstriction).