Head — MCQs

Head Indian Medical PG Practice Questions and MCQs

Question 541: Which of the following nerves does NOT supply the external ear?

A. Greater occipital nerve (Correct Answer)
B. Greater auricular nerve
C. Auriculotemporal nerve
D. Lesser occipital nerve

Explanation: The sensory innervation of the external ear (auricle) is a high-yield topic in NEET-PG Anatomy, involving both cranial and spinal nerves. ### **Explanation of the Correct Answer** **A. Greater Occipital Nerve (C2):** This nerve supplies the skin of the **posterior scalp** up to the vertex. It does **not** contribute to the sensory supply of the auricle. This is a common distractor because it sounds similar to the Lesser Occipital Nerve, which does supply the ear. ### **Analysis of Incorrect Options** * **B. Greater Auricular Nerve (C2, C3):** This is the primary nerve supply to the auricle. It supplies the lower part of the cranial (medial) surface and the lateral surface (lobule, helix, and antihelix). * **C. Auriculotemporal Nerve (CN V3):** A branch of the mandibular nerve, it supplies the tragus, the crus of the helix, and the adjacent upper part of the lateral surface. * **D. Lesser Occipital Nerve (C2):** This nerve supplies the skin of the upper part of the cranial (medial) surface of the auricle. ### **High-Yield Clinical Pearls for NEET-PG** 1. **The "Hidden" Nerve:** The **Auricular branch of the Vagus (Arnold’s nerve)** supplies the concha and external auditory canal. Stimulation of this nerve (e.g., cleaning the ear) can trigger a **reflex cough** (Arnold's reflex) or even fainting (vasovagal syncope). 2. **Facial Nerve (CN VII):** A small area of the concha and retroauricular groove is supplied by the facial nerve. This explains the vesicles seen in the ear in **Ramsay Hunt Syndrome**. 3. **Summary Rule:** The auricle is supplied by **CN V3, CN VII, CN X**, and the **Cervical Plexus (C2, C3)**. The Greater Occipital nerve is the only "occipital" nerve that stays on the scalp.

Question 542: Secretomotor fibers to the submandibular ganglion are carried by which nerve?

A. Facial nerve (Correct Answer)
B. Mandibular nerve
C. Glossopharyngeal nerve
D. Lingual nerve

Explanation: ### Explanation The **submandibular ganglion** is a parasympathetic ganglion responsible for the secretomotor supply to the submandibular and sublingual salivary glands. **Why Facial Nerve is Correct:** The preganglionic parasympathetic (secretomotor) fibers originate in the **superior salivatory nucleus** of the pons. These fibers travel via the **nervus intermedius** (a branch of the **Facial nerve/CN VII**) and then enter the **chorda tympani** nerve. The chorda tympani exits the skull and joins the **lingual nerve** in the infratemporal fossa, which eventually carries these fibers to the submandibular ganglion for synapse. Therefore, the primary source of these secretomotor fibers is the Facial nerve. **Why Other Options are Incorrect:** * **Mandibular nerve (V3):** While the lingual nerve is a branch of V3, the mandibular nerve itself does not carry secretomotor fibers; it only provides the "pathway" for fibers originating from CN VII. * **Glossopharyngeal nerve (CN IX):** This nerve carries secretomotor fibers to the **parotid gland** via the otic ganglion (inferior salivatory nucleus → lesser petrosal nerve). * **Lingual nerve:** This is a common distractor. The lingual nerve is a branch of the mandibular nerve that **physically carries** the fibers to the ganglion, but it does not *originate* them. The question asks which nerve "carries" the functional secretomotor fibers from the brainstem, which is the Facial nerve. **High-Yield NEET-PG Pearls:** * **Pathway Summary:** Superior salivatory nucleus → Facial nerve → Chorda tympani → Lingual nerve → Submandibular ganglion → Postganglionic fibers to glands. * **Chorda Tympani:** Also carries special visceral afferent (taste) fibers from the anterior 2/3rd of the tongue. * **Relay:** All salivary glands relay in a ganglion except the minor salivary glands.

Question 543: What type of cartilage is present in the ear pinna?

A. Yellow cartilage
B. Elastic cartilage (Correct Answer)
C. Fibrocartilage
D. None of the above

Explanation: **Explanation:** The ear pinna (auricle) is composed of a single piece of **Elastic Cartilage** (also known as yellow elastic cartilage). This type of cartilage is characterized by a dense network of branching elastic fibers within its matrix, providing the pinna with its characteristic flexibility and ability to recoil to its original shape after being folded or deformed. **Why the other options are incorrect:** * **Yellow Cartilage:** This is actually a synonym for Elastic Cartilage. However, in standard anatomical nomenclature and NEET-PG patterns, "Elastic Cartilage" is the preferred technical term. While Option A is technically a description of the color, Option B is the standard histological classification. * **Fibrocartilage:** This is the strongest type of cartilage, containing thick bundles of Type I collagen. It is found in areas requiring high tensile strength and weight-bearing, such as the intervertebral discs, pubic symphysis, and glenoid labrum. It lacks the flexibility required for the ear pinna. **High-Yield Clinical Pearls for NEET-PG:** * **Mnemonics for Elastic Cartilage:** Remember the **"3 Es"** or **"6 Es"**: **E**ar pinna, **E**xternal auditory canal (lateral 1/3), **E**ustachian tube (cartilaginous part), **E**piglottis, and the small laryngeal cartilages—**E**piform (Cuneiform) and Corniculate. * **Histology Note:** Unlike hyaline cartilage, elastic cartilage does not calcify with age. * **Clinical Correlation:** In **"Cauliflower Ear"** (perichondrial hematoma), trauma causes blood to accumulate between the perichondrium and the elastic cartilage, compromising the blood supply and leading to necrosis and fibrosis.

Question 544: What structures are transmitted through the incisive foramen?

A. Greater palatine artery and greater palatine nerve
B. Greater palatine artery and lesser palatine nerve
C. Greater palatine artery and sphenopalatine nerve
D. Greater palatine artery and nasopalatine nerve (Correct Answer)

Explanation: ### Explanation The **incisive foramen** is a funnel-shaped opening located in the midline of the hard palate, posterior to the maxillary incisor teeth. It serves as the communication point between the oral cavity and the nasal cavity. **Why Option D is Correct:** The incisive foramen transmits the terminal branches of two major neurovascular structures that provide sensory and blood supply to the palate: 1. **Nasopalatine Nerve:** A branch of the maxillary nerve ($V_2$) that descends from the nasal septum to provide sensory innervation to the anterior part of the hard palate. 2. **Greater Palatine Artery:** Specifically, its terminal branch. This artery originates from the maxillary artery, descends through the greater palatine canal, and travels forward on the palate to enter the incisive foramen, where it anastomoses with the septal branches of the sphenopalatine artery. **Analysis of Incorrect Options:** * **Options A & B:** The **Greater Palatine Nerve** and **Lesser Palatine Nerve** pass through the *Greater* and *Lesser Palatine Foramina*, respectively. They do not pass through the incisive foramen. * **Option C:** While the **Sphenopalatine Nerve** is related to the nasal cavity, it is the specific branch known as the *Nasopalatine Nerve* that traverses the incisive canal. **High-Yield Clinical Pearls for NEET-PG:** * **Anastomosis:** The incisive foramen is a site of a clinically significant anastomosis between the **Greater Palatine Artery** (from the palate) and the **Sphenopalatine Artery** (from the nasal cavity). * **Nerve Block:** The nasopalatine nerve block is performed by injecting local anesthetic near the incisive foramen to numb the palatal mucosa of the six anterior maxillary teeth. * **Incisive Canal:** The foramen leads into the incisive canal, which often opens into the nasal cavity via two separate "Foramina of Stenson."

Question 545: Where are crypts typically seen?

A. Tonsils (Correct Answer)
B. Adenoids
C. Lymph nodes
D. Parotids

Explanation: The correct answer is **A. Tonsils**. **Why Tonsils are correct:** The palatine tonsils are masses of lymphoid tissue located in the lateral wall of the oropharynx. They are covered by **non-keratinized stratified squamous epithelium**. This surface epithelium invaginates deeply into the underlying lymphoid parenchyma to form **tonsillar crypts** (approximately 12–15 in number). The largest of these is the *crypta magna*. These crypts serve to increase the surface area for contact between environmental antigens and the immune system, but they can also trap food debris and bacteria, leading to the formation of tonsilloliths (tonsil stones). **Why other options are incorrect:** * **B. Adenoids (Pharyngeal Tonsils):** Unlike palatine tonsils, adenoids are covered by **ciliated pseudostratified columnar epithelium** (respiratory epithelium). Their surface is characterized by longitudinal mucosal folds or pleats rather than deep, branching crypts. * **C. Lymph nodes:** Lymph nodes are encapsulated structures that contain a subcapsular sinus, cortex, and medulla. They do not possess an epithelial covering or crypts; instead, they filter lymph via afferent and efferent vessels. * **D. Parotids:** These are major salivary glands composed of serous acini and a branching ductal system. They do not contain lymphoid crypts. **High-Yield NEET-PG Pearls:** * **Epithelium:** Palatine tonsil = Stratified squamous; Adenoid = Respiratory epithelium. * **Embryology:** The palatine tonsil develops from the **second pharyngeal pouch**. * **Blood Supply:** The main artery is the **tonsillar branch of the facial artery**. * **Clinical:** The most common site of infection in the oropharynx is the tonsillar crypts. The "tonsillar node" of Jugulodigastric group is the primary lymph node involved in tonsillitis.

Question 546: All of the following glands are supplied by the facial nerve, EXCEPT:

A. Nasal glands
B. Lacrimal gland
C. Parotid gland (Correct Answer)
D. Submandibular gland

Explanation: The **Facial Nerve (CN VII)** provides secretomotor (parasympathetic) supply to all major salivary glands and mucosal glands of the head, **except for the parotid gland**. ### **Why Parotid Gland is the Correct Answer:** The **Parotid gland** receives its parasympathetic secretomotor supply from the **Glossopharyngeal nerve (CN IX)**. The pathway involves the inferior salivatory nucleus → tympanic nerve → tympanic plexus → **lesser petrosal nerve** → **otic ganglion** (synapse) → auriculotemporal nerve (branch of V3) → Parotid gland. ### **Why Other Options are Incorrect:** * **Nasal glands & Lacrimal gland:** These are supplied by the **Greater Petrosal nerve** (a branch of CN VII). The fibers synapse in the **pterygopalatine ganglion** before reaching their targets. * **Submandibular gland:** This gland (along with the sublingual gland) is supplied by the **Chorda tympani** branch of CN VII. The fibers join the lingual nerve and synapse in the **submandibular ganglion**. ### **High-Yield Clinical Pearls for NEET-PG:** * **The "Rule of 7":** CN VII supplies all glands above the oral fissure (lacrimal, nasal, palatal) via the pterygopalatine ganglion and those in the floor of the mouth via the submandibular ganglion. * **Ganglion Summary:** * CN VII → Pterygopalatine & Submandibular Ganglia. * CN IX → Otic Ganglion (Parotid). * **Clinical Correlation:** In **Bell’s Palsy**, if the lesion is proximal to the origin of the greater petrosal nerve, the patient will present with a "dry eye" due to loss of lacrimation.

Question 547: The auriculotemporal nerve supplies which gland?

A. Lacrimal gland
B. Parotid gland (Correct Answer)
C. Submandibular gland
D. Sublingual gland

Explanation: **Explanation:** The **auriculotemporal nerve**, a branch of the posterior division of the mandibular nerve ($V_3$), provides the secretomotor pathway for the **parotid gland**. While the nerve itself is a branch of the trigeminal nerve, it carries postganglionic parasympathetic fibers from the **otic ganglion**. These fibers originate from the glossopharyngeal nerve ($CN\ IX$), pass through the lesser petrosal nerve to the otic ganglion, and are then "hitchhiked" by the auriculotemporal nerve to reach the parotid gland. **Analysis of Options:** * **B. Parotid gland (Correct):** As described, it receives its parasympathetic supply via the auriculotemporal nerve. It also provides sensory supply to the parotid fascia. * **A. Lacrimal gland:** Supplied by the lacrimal nerve (branch of $V_1$), which carries parasympathetic fibers originating from the **facial nerve** ($CN\ VII$) via the pterygopalatine ganglion. * **C. & D. Submandibular and Sublingual glands:** Both are supplied by the **chorda tympani** (branch of $CN\ VII$), which joins the lingual nerve to reach the submandibular ganglion for synapse [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Frey’s Syndrome:** Occurs due to injury to the auriculotemporal nerve (often during parotid surgery). During regeneration, parasympathetic fibers mistakenly grow into the overlying sweat glands, leading to **gustatory sweating** (sweating while eating). * **Referred Pain:** Since the auriculotemporal nerve also supplies the **TMJ** and the **external auditory canal**, pathology in the parotid gland or TMJ can cause referred pain to the ear. * **Otic Ganglion:** Remember the mnemonic **L-O-A-P** (Lesser petrosal – Otic ganglion – Auriculotemporal nerve – Parotid).

Question 548: Which of the following is NOT supplied by the secretomotor fibers of the facial nerve?

A. Lacrimal gland
B. Parotid gland (Correct Answer)
C. Submandibular gland
D. Nasal glands

Explanation: The **Facial Nerve (CN VII)** provides parasympathetic secretomotor supply to all major glands of the head and neck, **except the parotid gland**. ### Why the Parotid Gland is the Correct Answer The **Parotid gland** is supplied by the **Glossopharyngeal nerve (CN IX)**. The pathway involves the tympanic nerve, the lesser petrosal nerve, and a relay in the **otic ganglion**. Postganglionic fibers then reach the gland via the auriculotemporal nerve. ### Explanation of Incorrect Options * **Lacrimal Gland:** Supplied by CN VII via the **Greater Petrosal Nerve**. Fibers relay in the **pterygopalatine ganglion** and reach the gland via the zygomatic and lacrimal nerves. * **Submandibular Gland:** Supplied by CN VII via the **Chorda Tympani**. Fibers join the lingual nerve and relay in the **submandibular ganglion**. * **Nasal Glands:** Like the lacrimal gland, these are supplied by CN VII via the **Greater Petrosal Nerve** and relay in the **pterygopalatine ganglion**. ### High-Yield NEET-PG Pearls * **The "Rule of 7":** The Facial nerve (VII) supplies the "7-shaped" distribution of glands (Lacrimal, Nasal, Palatine, Submandibular, and Sublingual). * **Nucleus:** The secretomotor fibers of CN VII originate from the **Superior Salivatory Nucleus**, while those for CN IX (parotid) originate from the **Inferior Salivatory Nucleus**. * **Clinical Correlation:** In **Frey’s Syndrome**, damage to the auriculotemporal nerve leads to "gustatory sweating" because parasympathetic fibers meant for the parotid gland regrow to innervate sweat glands in the overlying skin.

Question 549: The stapes footplate covers which anatomical structure?

A. Round window
B. Oval window (Correct Answer)
C. Inferior sinus tympani
D. Pyramid

Explanation: The middle ear transmits sound vibrations from the tympanic membrane to the inner ear via the ossicular chain. The **stapes**, the smallest bone in the human body, consists of a head, two crura, and a **footplate (base)** [1]. **Why the Oval Window is Correct:** The footplate of the stapes is attached to the margins of the **Oval Window (Fenestra Vestibuli)** by the annular ligament [2]. This connection serves as the interface between the middle ear and the vestibule of the inner ear. When the stapes vibrates, the footplate acts like a piston, pushing against the perilymph of the inner ear to initiate a fluid wave [3]. **Analysis of Incorrect Options:** * **Round Window (Fenestra Cochleae):** This is located postero-inferior to the oval window and is closed by the secondary tympanic membrane. It serves as a pressure release valve for the fluid waves created by the stapes. * **Inferior Sinus Tympani:** This is a deep recess in the posterior wall of the tympanic cavity, located medial to the pyramid and subiculum. It is a common site for residual cholesteatoma but has no direct contact with the stapes footplate. * **Pyramid:** This is a hollow, cone-shaped bony projection on the posterior wall of the middle ear that houses the **Stapedius muscle** [2]. While the stapedius tendon emerges from the pyramid to attach to the neck of the stapes, the pyramid itself is not covered by the footplate. **NEET-PG High-Yield Pearls:** * **Otosclerosis:** A condition characterized by pathological bone remodeling that fixes the stapes footplate in the oval window, leading to conductive hearing loss. * **Development:** The stapes footplate has a dual origin: the medial part develops from the **otic capsule**, while the rest develops from the **second branchial arch (Reichert’s cartilage)**. * **Nerve Supply:** The stapedius muscle is supplied by the **Facial Nerve (CN VII)**; its paralysis leads to hyperacusis.

Question 550: The upper first molar is supplied by which nerve?

A. Superior alveolar nerve (Correct Answer)
B. Inferior alveolar nerve
C. Mental nerve
D. Lingual nerve

Explanation: The innervation of the teeth is a high-yield topic in head and neck anatomy, primarily involving the branches of the **Trigeminal nerve (CN V)**. ### **Explanation of the Correct Answer** The **upper (maxillary) teeth** are supplied by the **Superior Alveolar nerves**, which are branches of the Maxillary nerve (V2). Specifically: * **Posterior Superior Alveolar (PSA) nerve:** Supplies the maxillary molars (except the mesiobuccal root of the 1st molar in some individuals). * **Middle Superior Alveolar (MSA) nerve:** Supplies the maxillary premolars and the mesiobuccal root of the 1st molar. * **Anterior Superior Alveolar (ASA) nerve:** Supplies the maxillary incisors and canines. Since the question asks for the general nerve supply of the upper first molar, **Superior Alveolar nerve** is the most accurate choice. ### **Why Other Options are Incorrect** * **B. Inferior Alveolar Nerve:** This is a branch of the Mandibular nerve (V3) and supplies all the **lower (mandibular) teeth**. * **C. Mental Nerve:** A terminal branch of the inferior alveolar nerve that exits the mental foramen to supply the skin of the chin and the lower lip. * **D. Lingual Nerve:** A branch of V3 that provides general sensation to the anterior 2/3rd of the tongue and the floor of the mouth; it does not supply the teeth. ### **NEET-PG Clinical Pearls** * **The "MB Root" Exception:** A classic exam favorite is that the **mesiobuccal root** of the maxillary 1st molar is often supplied by the **Middle** Superior Alveolar nerve, while the rest of the tooth is supplied by the **Posterior** Superior Alveolar nerve. * **PSA Nerve Block:** When performing a PSA block, clinicians must be careful of the **Pterygoid venous plexus** to avoid hematoma formation. * **Maxillary Sinusitis:** Pain from the maxillary sinus can often be referred to the upper molars because they share the same nerve supply (Superior Alveolar nerves).

Practice by Chapter

Skull and Facial Bones

Practice Questions

Scalp and Facial Muscles

Practice Questions

Dural Venous Sinuses

Practice Questions

Cranial Cavity

Practice Questions

Orbit and Contents

Practice Questions

Temporal and Infratemporal Regions

Practice Questions

Pterygopalatine Fossa

Practice Questions

Oral Cavity

Practice Questions

Paranasal Sinuses

Practice Questions

Applied Anatomy and Clinical Correlations

Practice Questions

Want unlimited practice?

Get full access to all questions, explanations, and performance tracking.

Start For Free

Head — MCQs

Head — MCQs

On this page

Practice by Chapter

Want unlimited practice?