Head Practice Questions

Q: Hypoglossal nerve supplies all of these muscles except:-

Palatoglossus. ***Palatoglossus*** - The **palatoglossus** muscle is innervated by the **pharyngeal plexus** (composed of contributions from the vagus and glossopharyngeal nerves), not the hypoglossal nerve. - It is the only extrinsic muscle of the tongue not supplied by the hypoglossal nerve, and its primary function is to elevate the posterior part of the tongue and narrow the oropharyngeal isthmus. *Styloglossus* - The **styloglossus** muscle is an **extrinsic tongue muscle** that originates from the styloid process and inserts into the side and undersurface of the tongue. - It is supplied by the **hypoglossal nerve** and acts to retract and elevate the tongue. *Genioglossus* - The **genioglossus** muscle is an **extrinsic tongue muscle** that originates from the mental spine of the mandible. - It is innervated by the **hypoglossal nerve** and is responsible for protruding and depressing the tongue, and its bilateral contraction is crucial in preventing airway obstruction during sleep (tongue falling back). *Hyoglossus* - The **hyoglossus** muscle is an **extrinsic tongue muscle** that originates from the hyoid bone and inserts into the side of the tongue. - It is supplied by the **hypoglossal nerve** and acts to depress and retract the tongue.

Q: Cutaneous supply over the parotid gland is by:

Greater auricular nerve. ***Greater auricular nerve*** - The **greater auricular nerve**, a branch of the cervical plexus (C2-C3), is the **primary cutaneous nerve** supplying sensation to the skin over the parotid gland and the angle of the mandible. - It ascends from behind the sternocleidomastoid muscle and provides the main sensory innervation to the parotid region, making it the most important nerve for this area. *Auriculotemporal nerve* - The **auriculotemporal nerve** (branch of mandibular division of trigeminal nerve) supplies sensory innervation to the skin of the temporal region, the external auditory meatus, and the tympanic membrane. - While it provides some cutaneous supply to the upper/posterior part of the parotid region, the **greater auricular nerve is the primary cutaneous nerve** over the parotid gland proper. - It also carries postganglionic parasympathetic fibers (from otic ganglion) to the parotid gland for secretomotor function. *Greater occipital nerve* - The **greater occipital nerve** is responsible for cutaneous sensation to the posterior scalp, up to the vertex of the head. - It arises from the dorsal ramus of C2 and has no role in the cutaneous supply over the parotid gland. *Facial nerve* - The **facial nerve (CN VII)** is primarily a motor nerve that controls the muscles of facial expression. - While it passes through the parotid gland and divides within it, it does not provide cutaneous sensory innervation to the skin overlying the gland.

Q: Which structure doesn't pass through the parotid gland?

Internal Carotid Artery. ***Internal Carotid Artery*** - The **internal carotid artery** does not pass through the parotid gland; it is located medial to the gland. - It ascends in the neck to supply the brain and does not traverse the glandular parenchyma. *Retromandibular vein* - The retromandibular vein is formed within the parotid gland by the union of the **superficial temporal vein** and the **maxillary vein**. - It then exits the gland and divides into anterior and posterior divisions. *Facial nerve* - The **facial nerve (cranial nerve VII)** enters the posterior aspect of the parotid gland and divides into its five terminal branches within the gland. - It supplies motor innervation to the **muscles of facial expression**. *External Carotid Artery and its branches* - The **external carotid artery** passes through the parotid gland, where it gives off several important branches. - The main branches within the gland are the **maxillary artery** and the **superficial temporal artery**.

Q: Protrusion of mandible is due to which of the following muscles?

Lateral pterygoid. ***Lateral pterygoid*** - The **lateral pterygoid muscle** is the primary muscle responsible for **protrusion of the mandible**. - Its bilateral contraction pulls the condyle of the mandible and the articular disc anteriorly, causing the lower jaw to move forward. *Medial pterygoid* - The **medial pterygoid muscle** primarily functions in **elevation** and **side-to-side movements** of the mandible. - While it assists in some mandibular movements, its main role is not protrusion. *Masseter* - The **masseter muscle** is a strong muscle involved in **elevating the mandible** and is crucial for **closing the jaw** (biting and chewing). - It does not contribute significantly to the forward movement or protrusion of the mandible. *Temporalis* - The **temporalis muscle** is a major muscle of mastication, responsible for **elevating the mandible** and **retracting** it. - Its fibers, particularly the posterior ones, pull the mandible backward, directly opposing protrusion.

Q: Which of the following is the safety muscle of tongue?

Genioglossus. ***Genioglossus*** - The **genioglossus muscle** is considered the safety muscle of the tongue because its contraction pulls the tongue forward, preventing it from falling backward and **obstructing the airway**, especially during sleep or in an unconscious state. - Its forward action is crucial in maintaining a **patent airway** [1]. *Hyoglossus* - The **hyoglossus muscle** depresses and retracts the tongue. - Its primary action is not to prevent airway obstruction, but rather for **tongue movement** during speech and swallowing. *Styloglossus* - The **styloglossus muscle** retracts and elevates the tongue. - It helps in shaping the tongue for **swallowing and speech**, but does not have a primary role in airway patency. *Palatoglossus* - The **palatoglossus muscle** elevates the posterior part of the tongue and depresses the soft palate. - It is involved in initiating **swallowing** and separating the oral cavity from the pharynx, not in preventing airway collapse.

Q: Which branch of facial nerve supplies muscles of lower lip

Marginal mandibular. ***Marginal mandibular*** - The **marginal mandibular branch** of the facial nerve innervates muscles of the lower lip and chin, including the **depressor labii inferioris**, **depressor anguli oris**, and **mentalis**. - Damage to this nerve causes an inability to depress the lower lip, leading to an **asymmetric smile**. *Buccal* - The **buccal branch** primarily innervates the **buccinator muscle** and the muscles of the upper lip. - It is crucial for **cheek compression** (e.g., blowing or sucking) and expression around the mouth. *Cervical* - The **cervical branch** supplies the **platysma muscle**, a broad sheet of muscle in the neck that helps depress the mandible and draw down the corners of the mouth. - It does not directly innervate the muscles of the lower lip. *Temporal* - The **temporal branch** provides motor innervation to the muscles of the forehead and around the eye, including the **frontalis** and **orbicularis oculi**. - It is responsible for actions like raising the eyebrows and closing the eyelids.

Q: Trismus is due to spasm of which of the following muscles

Medial pterygoid. ***Medial pterygoid*** - **Trismus** is characterized by persistent spasm of the **muscles of mastication**, leading to difficulty opening the mouth. - The **medial pterygoid** is a strong jaw **closer** muscle, and its spasm contributes significantly to trismus along with other masticatory muscles (masseter and temporalis). - Among the given options, medial pterygoid is the muscle of mastication that causes trismus when in spasm. *Mentalis* - The **mentalis muscle** is primarily involved in **pouting** and elevating the lower lip. - While it affects the lower face, it does not directly control jaw opening or closing to cause trismus. - It is **not a muscle of mastication**. *Lateral pterygoid* - The **lateral pterygoid muscle** is primarily responsible for **depressing** (opening) the jaw and is also involved in protrusion and side-to-side movements. - While it is a muscle of mastication, in the context of trismus (jaw closure spasm), the **medial pterygoid** (jaw closer) is more directly implicated than the lateral pterygoid. *Buccinator* - The **buccinator muscle** forms the muscular wall of the cheek and is involved in **chewing**, whistling, and keeping food between the teeth. - It does not directly control jaw opening or closing, and its spasm would not be the primary cause of trismus. - It is **not a muscle of mastication**.

Q: Orbital blow-out fracture involves:

Medial wall and floor of orbit. Medial wall and floor of orbit - An orbital blow-out fracture typically involves the **medial wall** (lamina papyracea of the ethmoid bone) and the **floor** (maxillary bone) of the orbit because these are the weakest bony structures. - The force of impact on the globe is transmitted to the orbital walls, causing them to fracture outwards into the adjacent sinuses. *Lateral wall and roof of orbit* - The **lateral wall** (zygomatic bone) and **roof** (frontal bone) of the orbit are structurally strong and less commonly involved in isolated blow-out fractures. - Fractures in these areas typically result from high-impact trauma and are often associated with other facial bone injuries. *Medial wall and roof of orbit* - While the **medial wall** is frequently involved, the **roof** of the orbit is a thick, sturdy bone and is less susceptible to blow-out forces. - Fractures of the orbital roof usually occur due to direct impact or high-energy trauma to the forehead. *Lateral wall and floor of orbit* - Although the **floor** is commonly fractured, the **lateral wall** is a robust structure and is not typically involved in isolated blow-out fractures. - Combined fractures of the lateral wall and floor would indicate a more extensive orbital impact, often with other mid-facial trauma.

Q: Middle meningeal artery is a branch of which artery?

Maxillary artery. ***Maxillary artery*** - The **middle meningeal artery** is a major branch of the **maxillary artery**, which itself is a terminal branch of the **external carotid artery**. - It supplies blood to the **dura mater** and cranial bones and is notably vulnerable to injury in temporal bone fractures. *Superficial temporal artery* - The **superficial temporal artery** is the other terminal branch of the **external carotid artery** (alongside the maxillary artery). - It supplies the scalp and superficial temporal region but does not give rise to the middle meningeal artery. *Facial artery* - The **facial artery** is a branch of the **external carotid artery** but primarily supplies structures of the face, such as muscles of facial expression and superficial facial tissues. - It does not give rise to the middle meningeal artery, which has an intracranial course. *Ophthalmic artery* - The **ophthalmic artery** is a branch of the **internal carotid artery** and supplies structures within the orbit, including the eye. - It does not contribute to the blood supply of the dura mater in the area supplied by the middle meningeal artery.

Q: Sensory innervation of the cornea is by which nerve?

5th (ophthalmic division of the trigeminal nerve). ***5th (ophthalmic division of the trigeminal nerve)*** - The **trigeminal nerve (CN V)** is responsible for sensory innervation of the face, and its **ophthalmic division (V1)** specifically supplies the cornea. - This extensive sensory innervation explains the **extreme sensitivity of the cornea** to touch, temperature, and chemicals, and is crucial for the **corneal reflex**. *6th (Abducens nerve)* - The **abducens nerve (CN VI)** is a **motor nerve** responsible for innervating the **lateral rectus muscle**, which abducts the eye. - It has no role in the sensory innervation of the cornea. *3rd (Oculomotor nerve)* - The **oculomotor nerve (CN III)** is primarily a **motor nerve** responsible for innervating most of the **extraocular muscles** (superior, inferior, medial recti, inferior oblique) and the **levator palpebrae superioris**. - It also carries **parasympathetic fibers** for pupillary constriction and accommodation, but it does not provide sensory innervation to the cornea. *4th (Trochlear nerve)* - The **trochlear nerve (CN IV)** is a **motor nerve** that innervates the **superior oblique muscle**, which depresses and internally rotates the eye. - It has no function in corneal sensation.

Question 1

Hypoglossal nerve supplies all of these muscles except:-

Accepted Answer

Palatoglossus

Answer

Styloglossus

Answer

Genioglossus

Answer

Hyoglossus

Question 2

Cutaneous supply over the parotid gland is by:

Accepted Answer

Greater auricular nerve

Answer

Auriculotemporal nerve

Answer

Greater occipital nerve

Answer

Facial nerve

Question 3

Which structure doesn't pass through the parotid gland?

Accepted Answer

Internal Carotid Artery

Answer

Retromandibular vein

Answer

Facial nerve

Answer

External Carotid Artery and its branches

Question 4

Protrusion of mandible is due to which of the following muscles?

Accepted Answer

Lateral pterygoid

Answer

Medial pterygoid

Answer

Masseter

Answer

Temporalis

Question 5

Which of the following is the safety muscle of tongue?

Accepted Answer

Genioglossus

Answer

Hyoglossus

Answer

Styloglossus

Answer

Palatoglossus

Question 6

Which branch of facial nerve supplies muscles of lower lip

Accepted Answer

Marginal mandibular

Answer

Buccal

Answer

Cervical

Answer

Temporal

Question 7

Trismus is due to spasm of which of the following muscles

Accepted Answer

Medial pterygoid

Answer

Mentalis

Answer

Lateral pterygoid

Answer

Buccinator

Question 8

Orbital blow-out fracture involves:

Accepted Answer

Medial wall and floor of orbit

Answer

Lateral wall and roof of orbit

Answer

Medial wall and roof of orbit

Answer

Lateral wall and floor of orbit

Question 9

Middle meningeal artery is a branch of which artery?

Accepted Answer

Maxillary artery

Answer

Superficial temporal artery

Answer

Facial artery

Answer

Ophthalmic artery

Question 10

Sensory innervation of the cornea is by which nerve?

Accepted Answer

5th (ophthalmic division of the trigeminal nerve)

Answer

6th (Abducens nerve)

Answer

3rd (Oculomotor nerve)

Answer

4th (Trochlear nerve)

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