Neck Practice Questions

Q: Which structures are marked as $X$ and $Y$ ?

$X=$ Vertebral artery, $Y=$ Carotid sinus. ***Option: X = Vertebral artery, Y = Carotid sinus*** * **X** points to the **vertebral artery**, which arises from the subclavian artery and ascends through the transverse foramina of the cervical vertebrae (C1-C6). * **Y** points to the **carotid sinus**, a dilated area at the base of the internal carotid artery, containing baroreceptors that monitor blood pressure. *Option: X = Thyrocervical trunk, Y = Carotid sinus* * The **thyrocervical trunk** is a short, wide vessel arising from the subclavian artery, typically more medially located and not depicted as X in this image. * While Y is correctly identified as the carotid sinus, X is incorrectly identified. *Option: X = Innominate artery, Y = Aortic sinus* * The **innominate artery** (brachiocephalic artery) is the first branch of the aortic arch and does not extend as far laterally as X, which represents an artery supplying the cervical vertebrae. * The **aortic sinus** is located at the root of the aorta in the thorax, not in the neck region as indicated by Y. *Option: X = Internal mammary artery, Y = Carotid sinus* * The **internal mammary artery** (internal thoracic artery) branches from the subclavian artery and descends inferiorly deep to the sternum, not laterally as X is depicted. * While Y is correctly identified as the carotid sinus, X is incorrectly identified.

Q: Identify the triangle shown in the figure below:

No options provided, so I cannot create an explanation with incorrect options. Please provide correct option to proceed.

Q: Identify the structure marked as $X$ below:

Arytenoid cartilage. ***Arytenoid cartilage*** - The image displays a superior view of the larynx, with **E** pointing to the **epiglottis**. The structures labeled **X** are located posterior and inferior to the epiglottis, consistent with the position of the **arytenoid cartilages**. - The arytenoid cartilages are paired, pyramidal-shaped cartilages that articulate with the **cricoid cartilage** and play a crucial role in vocal cord movement and phonation.

Q: Identify the anatomical structures-X, Y, Z of the neck depicted below in that order: (APPG 2015)

Anterior belly of digastric, Carotid triangle, Omohyoid. **Anterior belly of digastric, Carotid triangle, Omohyoid** - **X** points to the **anterior belly of the digastric muscle**, which forms the anterior boundary of the digastric triangle. - **Y** marks the location of the **carotid triangle**, bounded by the posterior belly of the digastric, the sternocleidomastoid, and the superior belly of the omohyoid. - **Z** indicates the **omohyoid muscle**, specifically its superior belly, which is visible in this anterior perspective of the neck musculature. *Anterior belly of digastric, Digastric triangle, Stylohyoid* - While **X is the anterior belly of the digastric**, Y is not pointing to the digastric triangle itself but rather a different anatomical region. - **Z is clearly not the stylohyoid muscle**, as the stylohyoid is a more superior and posterior muscle, typically associated with the styloid process. *Posterior belly of digastric, Digastric triangle, Platysma* - **X is incorrectly identified as the posterior belly of the digastric**; it is the anterior belly. The posterior belly is located more inferior and posterior. - **Z is not the platysma**, which is a broad, superficial muscle of facial expression covering the anterolateral aspect of the neck. *Posterior belly of digastric, Muscular triangle, Omohyoid* - **X is incorrectly identified as the posterior belly of the digastric**; it is the anterior belly of the digastric. - **Y is not the muscular triangle**, which is located more medially and inferiorly, bounded by the omohyoid, sternocleidomastoid, and the midline of the neck.

Q: The Superior and side view of the larynx is shown below. Identify the Abductor of the vocal cords.

B. **B** - **B** points to the **posterior cricoarytenoid muscle** in both views, which is the sole abductor of the vocal cords, responsible for opening the rima glottidis. - This muscle pulls the muscular processes of the arytenoid cartilages posteriorly, rotating them laterally and separating the vocal folds to allow airflow for breathing. *A* - In the side view, **A** points to the **cricoid cartilage**, a foundational cartilage of the larynx. - In the superior view, **A** points to the **epiglottis**, which covers the laryngeal inlet during swallowing, preventing food from entering the trachea. *C* - In the side view, **C** points to the **lateral cricoarytenoid muscle**, which is an adductor of the vocal cords, responsible for closing the rima glottidis. - In the superior view, **C** points to the **thyroarytenoid muscle** (or vocalic muscle, part of the thyroarytenoid), which shortens and relaxes the vocal cords, lowering the pitch of the voice. *D* - In the side view, **D** points to the **thyroid cartilage**, the largest laryngeal cartilage, forming the anterior and lateral walls of the larynx. - In the superior view, **D** points to the **transverse arytenoid muscle**, an adductor of the vocal cords, which closes the posterior part of the rima glottidis by approximating the arytenoid cartilages.

Q: In this diagram, identify the structure whose paralysis causes decrease in respiratory movements: (AIIMS May 2016)

C. ***C*** - Structure C points to the **phrenic nerve** (C3-C5: "C3, 4, 5 keeps the diaphragm alive"), which primarily innervates the **diaphragm**. - The diaphragm is the **most important muscle of respiration**, responsible for approximately **70-80% of the work of breathing** during quiet respiration. - Paralysis of the phrenic nerve leads to **diaphragmatic paralysis**, significantly decreasing respiratory movements and causing respiratory compromise. *A* - Structure A points to a nerve arising from the **carotid sheath region**, likely representing a branch of the **cervical plexus** or a sympathetic nerve. - While these nerves have various functions (e.g., cutaneous innervation, vasomotor control), their paralysis does not directly cause a significant decrease in overall respiratory movements. *B* - Structure B points to the **subclavian artery**, which is a major blood vessel supplying blood to the upper limb and head/neck region. - Paralysis is a neurological term and does not apply to an artery; therefore, its occlusion or damage would lead to **ischemia** of supplied tissues, not a direct decrease in respiratory movements. *D* - Structure D points to the **trachea**, which is the main airway leading to the lungs. - The trachea is a cartilaginous tube, not a nerve or muscle that can be paralyzed; its obstruction would lead to **dyspnea** and respiratory distress, not decreased movements due to paralysis.

Q: Which structure passes through the area marked in red? (AIIMS May 2018)

Vertebral artery. ***Vertebral artery*** - The image displays a cervical vertebra, and the red-marked area highlights the **foramen transversarium** (or transverse foramen). This foramen is a defining feature of cervical vertebrae. - The **vertebral artery** ascends through these foramina in cervical vertebrae C1-C6, providing blood supply to the brain. *Anterior inferior cerebellar artery* - The **anterior inferior cerebellar artery (AICA)** is a branch of the basilar artery and supplies parts of the cerebellum and brainstem. - It is an **intracranial vessel** and does not pass through the foramina transversaria of the cervical vertebrae. *Transverse ligament* - The **transverse ligament of the atlas** is a crucial ligament that holds the dens of the axis against the anterior arch of the atlas. - It is located **within the vertebral canal**, posterior to the dens, not within the foramen transversarium of the transverse process. *Apical ligament* - The **apical ligament** connects the apex of the dens (odontoid process) of C2 (axis) to the anterior margin of the foramen magnum. - Like the transverse ligament, it is an **intracranial ligament** associated with the craniocervical junction, not a structure passing through the foramen transversarium.

Q: 8. Ans. (a) Quadrangular membrane

***Quadrangular membrane*** - The quadrangular membrane is a sheet of connective tissue that extends between the **arytenoid cartilage** and the lateral aspect of the **epiglottis**. - Its lower margin thickens to form the **vestibular ligament**, which is a key component of the false vocal cords.

Q: What does the marking X represent? (DNB Pattern 2018)

Crico-vocal membrane. ***Crico-vocal membrane*** - The marking X points to the **conus elasticus**, also known as the crico-vocal membrane. This membrane forms the main supporting ligament of the larynx. - Its superior free edge forms the **vocal ligament**, which is the core of the true vocal folds. *Quadrangular membrane* - The quadrangular membrane is located **superior** to the vocal folds, extending between the arytenoid and epiglottic cartilages. - Its lower free border forms the **vestibular ligament** (false vocal cord), which is superior to the position marked by X. *Thyro-hyoid membrane* - The thyro-hyoid membrane connects the **thyroid cartilage** to the **hyoid bone**. - It lies significantly superior to the structures shown in the region marked by X, which is within the larynx itself. *Hyo-epiglottic ligament* - The hyo-epiglottic ligament connects the **hyoid bone** to the **anterior surface of the epiglottis**. - This ligament is situated much higher in the neck and anterior to the structures depicted by the mark X.

Q: The marking X represents which muscle? (DNB Pattern 2018)

Cricothyroid muscle. ***Cricothyroid muscle*** - The image displays the larynx, and the structure marked 'X' is located on the **anterior and lateral aspect of the cricoid cartilage**, inferior to the thyroid cartilage. This anatomical position corresponds to the **cricothyroid muscle**. - This muscle is responsible for **tensing the vocal cords**, which is crucial for pitch alteration during phonation. *Posterior cricoarytenoid* - The **posterior cricoarytenoid muscle** is located on the **posterior aspect of the cricoid cartilage** and is responsible for **abducting the vocal cords**. - It would not be visible in this anterior-lateral view where 'X' is marked. *Lateral cricoarytenoid* - The **lateral cricoarytenoid muscle** is situated **deep to the thyroid cartilage** and its fibers run from the lateral part of the cricoid to the muscular process of the arytenoid cartilage. - Its primary function is to **adduct the vocal cords**, and it would not be the superficial muscle indicated by 'X' in this view. *Lateral part of thyroarytenoid* - The **thyroarytenoid muscle** forms the bulk of the vocal folds and runs from the thyroid cartilage to the arytenoid cartilage, largely located **within the vocal cords**. - The structure marked 'X' is clearly positioned externally on the laryngeal framework, not within the vocal folds.

Question 1

Which structures are marked as $X$ and $Y$ ?

Accepted Answer

$X=$ Vertebral artery, $Y=$ Carotid sinus

Answer

$X=$ Thyrocervical trunk, $Y=$ Carotid sinus

Answer

$X=$ Innominate artery, $Y=$ Aortic sinus

Answer

$X=$ Internal mammary artery, $Y=$ Carotid sinus

Question 2

Identify the triangle shown in the figure below:

Question 3

Identify the structure marked as $X$ below:

Accepted Answer

Arytenoid cartilage

Answer

Corniculate cartilage

Answer

Cuneiform cartilage

Answer

Thyroid cartilage

Question 4

Identify the anatomical structures-X, Y, Z of the neck depicted below in that order: (APPG 2015)

Accepted Answer

Anterior belly of digastric, Carotid triangle, Omohyoid

Answer

Anterior belly of digastric, Digastric triangle, Stylohyoid

Answer

Posterior belly of digastric, Digastric triangle, Platysma

Answer

Posterior belly of digastric, Muscular triangle, Omohyoid

Question 5

The Superior and side view of the larynx is shown below. Identify the Abductor of the vocal cords.

Accepted Answer

B

Answer

A

Answer

C

Answer

D

Question 6

In this diagram, identify the structure whose paralysis causes decrease in respiratory movements: (AIIMS May 2016)

Accepted Answer

C

Answer

A

Answer

B

Answer

D

Question 7

Which structure passes through the area marked in red? (AIIMS May 2018)

Accepted Answer

Vertebral artery

Answer

Anterior inferior cerebellar artery

Answer

Transverse ligament

Answer

Apical ligament

Question 8

8. Ans. (a) Quadrangular membrane

Question 9

What does the marking X represent? (DNB Pattern 2018)

Accepted Answer

Crico-vocal membrane

Answer

Quadrangular membrane

Answer

Thyro-hyoid membrane

Answer

Hyo-epiglottic ligament

Question 10

The marking X represents which muscle? (DNB Pattern 2018)

Accepted Answer

Cricothyroid muscle

Answer

Posterior cricoarytenoid

Answer

Lateral cricoarytenoid

Answer

Lateral part of thyroarytenoid

Neck — MCQs

Neck — MCQs

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