Head — MCQs
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What is the sensory nerve supply of the anterior two-thirds of the tongue?
Among the following trigeminal nerve divisions, which one is involved in orbital apex syndrome?
Opening of the nasolacrimal duct is located at:
What is the origin of the maxillary artery?
Ethmoid bone articulates with which of the following?
The direction of the nasolacrimal duct is
Muscles of mastication are supplied by which nerve?
Which part of the internal carotid artery does not give any branches?
Which of the following is NOT a part of the medial wall of the orbit?
Which nerve provides sensory supply to the vocal cords?
Head Indian Medical PG Practice Questions and MCQs
Question 1311: What is the sensory nerve supply of the anterior two-thirds of the tongue?
- A. Lingual Nerve (Correct Answer)
- B. Maxillary Nerve
- C. Glossopharyngeal Nerve
- D. Chorda tympani
Explanation: Lingual Nerve - The lingual nerve, a branch of the mandibular nerve (V3), provides general sensory innervation to the anterior two-thirds of the tongue. - This includes touch, pain, and temperature sensation from this region. Maxillary Nerve - The maxillary nerve (V2) provides sensory innervation to the maxilla, upper teeth, palate, and part of the face, but not the tongue's general sensation. - Its sensory distribution is primarily to the mid-face region and upper jaw. Glossopharyngeal Nerve - The glossopharyngeal nerve (CN IX) provides general sensation and taste to the posterior one-third of the tongue. - This nerve is also responsible for innervating the stylopharyngeus muscle and parotid gland. Chorda tympani - The chorda tympani, a branch of the facial nerve (CN VII), carries taste sensation from the anterior two-thirds of the tongue. - It does not provide general sensation (pain, touch, temperature) for this part of the tongue.
Question 1312: Among the following trigeminal nerve divisions, which one is involved in orbital apex syndrome?
- A. Olfactory nerve
- B. Mandibular division of trigeminal nerve
- C. Maxillary division of trigeminal nerve
- D. Ophthalmic division of trigeminal nerve (Correct Answer)
Explanation: ***Ophthalmic division of trigeminal nerve*** - Orbital apex syndrome involves deficits of nerves passing through the **superior orbital fissure** and **optic canal**, which includes the ophthalmic division of the trigeminal nerve (CN V1). - Involvement of CN V1 leads to **sensory loss** in the forehead, upper eyelid, and side of the nose. *Olfactory nerve* - The **olfactory nerve (CN I)** is responsible for the sense of smell and does not pass through the orbital apex. - Its involvement would manifest as **anosmia**, which is not a characteristic feature of orbital apex syndrome. *Maxillary division of trigeminal nerve* - The **maxillary division (CN V2)** exits the skull through the **foramen rotundum** and innervates the midface. - It is generally **not involved** in orbital apex syndrome, as its anatomical course is distinct from the structures within the orbital apex. *Mandibular division of trigeminal nerve* - The **mandibular division (CN V3)** exits the skull through the **foramen ovale** and innervates the lower face and muscles of mastication. - Its involvement is **not associated** with orbital apex syndrome, as it is anatomically distant from the orbital apex.
Question 1313: Opening of the nasolacrimal duct is located at:
- A. Inferior meatus (Correct Answer)
- B. Superior meatus
- C. Middle meatus
- D. Sphenoethmoidal recess
Explanation: ***Inferior meatus*** - The **nasolacrimal duct** drains tears from the eye into the nasal cavity. - Its opening is located in the **anterior part of the inferior meatus**, beneath the inferior concha. *Superior meatus* - This meatus lies beneath the **superior concha** and receives drainage from the **posterior ethmoidal air cells**. - It does not receive the opening of the nasolacrimal duct. *Middle meatus* - The **middle meatus** is located beneath the middle meatus is located beneath the middle concha and receives drainage from the **frontal sinus**, **maxillary sinus**, and **anterior/middle ethmoidal air cells**. - The nasolacrimal duct does not open into this meatus. *Sphenoethmoidal recess* - This is a small space superior to the **superior concha** and receives the opening of the **sphenoid sinus**. - It is not associated with the drainage of the nasolacrimal duct.
Question 1314: What is the origin of the maxillary artery?
- A. Maxillary artery.
- B. Facial artery.
- C. Angle of mandible.
- D. External carotid artery. (Correct Answer)
Explanation: ***External carotid artery*** - The **maxillary artery** is the larger of the two terminal branches of the **external carotid artery**. - It originates posterior to the neck of the mandible and travels through the **infratemporal fossa**. *Angle of mandible* - The **angle of the mandible** is an anatomical landmark where the body and ramus of the mandible meet and is not an arterial origin. - While the maxillary artery passes near the mandible, it arises from a larger vessel, not directly from this bone. *Maxillary artery* - This option incorrectly states the artery as its own origin; the **maxillary artery** is itself a branch, not a parent vessel for its own origin. - When discussing the origin of an artery, we refer to the larger vessel from which it branches. *Facial artery* - The **facial artery** is another major branch of the **external carotid artery** but it supplies the face and superficial structures. - It does not give rise to the maxillary artery; they are both distinct branches from the same parent vessel.
Question 1315: Ethmoid bone articulates with which of the following?
- A. Inferior turbinate (Correct Answer)
- B. Middle turbinate
- C. Superior turbinate
- D. All of the options
Explanation: Inferior turbinate - The ethmoid bone forms the superior and middle conchae (turbinates) and articulates with the independent inferior nasal concha (inferior turbinate). - This articulation is crucial for forming the lateral wall of the nasal cavity. Middle turbinate - The middle turbinate is actually part of the ethmoid bone itself, specifically a downward projection from the ethmoid labyrinth. - Thus, it does not "articulate" with the ethmoid bone in the sense of two separate bones joining. Superior turbinate - Similar to the middle turbinate, the superior turbinate is also a part of the ethmoid bone. - It arises from the ethmoid labyrinth and does not form a distinct articulation with the main body of the ethmoid, but rather is a component of it. All of the options - This option is incorrect because only the inferior turbinate articulates with the ethmoid bone. The middle and superior turbinates are integral parts of the ethmoid bone.
Question 1316: The direction of the nasolacrimal duct is
- A. Downwards, backwards and medially (Correct Answer)
- B. Downwards, backwards and laterally
- C. Downwards, forwards and medially
- D. Downwards, forwards and laterally
Explanation: ***Downwards, backwards and medially*** - The **nasolacrimal duct** extends from the lacrimal sac in the lacrimal fossa and courses **inferiorly, posteriorly, and medially** through the nasolacrimal canal. - It opens into the **lateral wall of the inferior meatus** of the nasal cavity, meaning the duct travels **medially** from the orbit into the nasal cavity. - This anatomical orientation facilitates the drainage of tears from the eye into the nasal cavity. *Downwards, backwards and laterally* - While the duct does extend **downwards and backwards**, it courses **medially** from the orbit towards the nasal cavity, not laterally. - A lateral direction would lead away from the nasal cavity, contradicting its drainage function. *Downwards, forwards and medially* - The nasolacrimal duct courses **posteriorly (backwards)** as it descends, not forwards. - Though it does travel medially, the forward direction is anatomically incorrect. *Downwards, forwards and laterally* - The duct courses **posteriorly (backwards)**, not forwards. - Additionally, it travels **medially** into the nasal cavity, not laterally away from it.
Question 1317: Muscles of mastication are supplied by which nerve?
- A. Mandibular nerve (CN V3) (Correct Answer)
- B. Facial nerve (CN VII)
- C. Hypoglossal nerve (CN XII)
- D. Vagus nerve (CN X)
Explanation: ***Mandibular nerve (CN V3)*** - The **mandibular nerve (CN V3)** is a branch of the trigeminal nerve and provides **motor innervation** to all muscles of mastication. - The **four muscles of mastication** are: **masseter**, **temporalis**, **medial pterygoid**, and **lateral pterygoid**. - CN V3 also supplies some additional muscles: anterior belly of the digastric, mylohyoid, tensor tympani, and tensor veli palatini (though these are not classified as muscles of mastication). *Facial nerve (CN VII)* - The **facial nerve (CN VII)** is primarily responsible for innervating the **muscles of facial expression**. - It also carries taste sensation from the anterior two-thirds of the tongue and provides secretomotor innervation to some salivary and lacrimal glands. *Hypoglossal nerve (CN XII)* - The **hypoglossal nerve (CN XII)** provides **motor innervation** to the extrinsic and intrinsic muscles of the **tongue**. - It plays a crucial role in tongue movements involved in speech and swallowing but not mastication. *Vagus nerve (CN X)* - The **vagus nerve (CN X)** has extensive innervation, supplying structures in the pharynx, larynx, and most of the **thoracic and abdominal viscera**. - While it has motor functions in swallowing and speech (via pharyngeal and laryngeal muscles), it does not directly innervate the muscles of mastication.
Question 1318: Which part of the internal carotid artery does not give any branches?
- A. Cervical part (Correct Answer)
- B. Cavernous part
- C. Cerebral part
- D. Petrous part
Explanation: ***Cervical part*** - The **cervical portion** of the internal carotid artery ascends within the neck, and its primary function is to transport blood to the brain and other parts of the head without giving off any branches. - This segment is crucial for delivering blood flow to the intracranial circulation, and its lack of branches helps to maintain a consistent pressure gradient. *Cavernous part* - The cavernous part of the internal carotid artery gives off several branches, including the **meningohypophyseal trunk** and the **inferolateral trunk**. - These branches supply structures within the **cavernous sinus**, dura mater, and cranial nerves. *Cerebral part* - The **cerebral portion** of the internal carotid artery is highly branched, giving rise to major arteries like the **ophthalmic artery**, **posterior communicating artery**, and the **anterior and middle cerebral arteries**. - These branches are essential for supplying blood to the brain, eye, and associated structures. *Petrous part* - The **petrous part** of the internal carotid artery gives off the **caroticotympanic artery** and the **artery of the pterygoid canal (vidian artery)**. - These branches supply structures within the middle ear and pterygoid canal, respectively.
Question 1319: Which of the following is NOT a part of the medial wall of the orbit?
- A. Tip of maxilla
- B. Frontal bone (Correct Answer)
- C. Ethmoid bone
- D. Lacrimal bone
Explanation: ***Frontal bone*** - The **frontal bone** forms the **orbital roof** and contributes to the superior and superomedial orbital margins. - It does NOT form part of the **medial wall** of the orbit itself. - This is the correct answer to what is NOT part of the medial wall. *Ethmoid bone* - The **ethmoid bone**, specifically its **lamina papyracea** (orbital plate), forms the largest component of the **medial wall** of the orbit. - It is thin and fragile, separating the orbit from the ethmoid air cells. *Lacrimal bone* - The **lacrimal bone** is a small, delicate bone that forms part of the **anterior medial wall** of the orbit. - It lies between the frontal process of maxilla anteriorly and the lamina papyracea posteriorly. - It contains the lacrimal fossa that houses the lacrimal sac. *Tip of maxilla* - The **frontal process of the maxilla** forms the **anterior-most part** of the **medial wall** of the orbit. - It articulates with the frontal bone superiorly and the lacrimal bone posteriorly.
Question 1320: Which nerve provides sensory supply to the vocal cords?
- A. Recurrent laryngeal nerve
- B. Internal laryngeal nerve (Correct Answer)
- C. Superior laryngeal nerve
- D. All of the options
Explanation: ***Internal laryngeal nerve*** - This nerve, a branch of the **superior laryngeal nerve**, is entirely sensory. - It provides **sensation to the laryngeal mucosa from the epiglottis down to and including the vocal folds**. - This is the **primary sensory nerve** to the vocal cords, particularly their superior surface. *Recurrent laryngeal nerve* - This nerve is primarily **motor**, innervating all intrinsic laryngeal muscles except the cricothyroid [1]. - It also provides sensory innervation to the **laryngeal mucosa below the vocal folds** and the inferior surface of the vocal cords [1]. - While it contributes some sensory supply, it is not the primary sensory nerve to the vocal cords. *Superior laryngeal nerve* - This nerve divides into the internal and external laryngeal nerves. - The internal branch provides the sensation, but the **superior laryngeal nerve itself** as a complete nerve trunk is not the specific answer. - The **internal laryngeal branch** is the precise anatomical structure responsible. *All of the options* - This is incorrect because while both internal and recurrent laryngeal nerves contribute sensory fibers, the **internal laryngeal nerve** is recognized as the **primary sensory nerve** to the vocal cords. - The superior laryngeal nerve acts through its internal branch, not as a direct supplier.
Practice by Chapter
Skull and Facial Bones
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Scalp and Facial Muscles
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Dural Venous Sinuses
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Cranial Cavity
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Orbit and Contents
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Temporal and Infratemporal Regions
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Pterygopalatine Fossa
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Oral Cavity
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Paranasal Sinuses
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Applied Anatomy and Clinical Correlations
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