A 7-year-old boy is brought to the emergency department with a high fever and oxygen desaturation. He had a tracheostomy placed as an infant and has been placed on mechanical ventilation intermittently. Since then, he has had several bouts of pneumonia similar to his current presentation. In addition, he has been deaf since birth but is able to communicate through sign language. He attends school and performs above average for his grade. Physical exam reveals underdeveloped cheekbones, hypoplasia of the mandible, and malformed ears. Abnormal development of which of the following structures is most likely responsible for this patient's symptoms?
ABranchial cleft 1
BBranchial pouch 3
CBranchial arch 2
DBranchial arch 1
EBranchial pouch 1
A 10-year-old boy comes for a post-operative clinic visit with his ENT surgeon three months after airway reconstruction surgery and placement of a tracheostomy tube. Since the surgery, he says that he has been able to breathe better and is now getting used to tracheostomy care and tracheostomy tube changes. In addition to this surgery, he has had over twenty surgeries to implant hearing aids, reconstruct his cheekbones, and support his jaw to enable him to swallow. He was born with these abnormalities and had difficult breathing, hearing, and eating throughout his childhood. Fortunately, he is now beginning to feel better and is able to attend public school where he is one of the best students in the class. Abnormal development of which of the following structures is most likely responsible for this patient's malformations?
ASecond branchial cleft
BFirst branchial pouch
CThird and fourth branchial pouches
DFirst branchial arch
ESecond branchial arch
A 25-year-old man presents to the clinic with a midline swelling in his neck. He is unsure about when it appeared. He denies any difficulty with swallowing or hoarseness. His past medical history is insignificant. On physical examination, there is a 1 cm x 2 cm firm mildly tender nodule on the anterior midline aspect of the neck which moves with deglutition and elevates with protrusion of the tongue. Which of the following is the most likely embryologic origin of the nodule in this patient?
AMidline endoderm of the pharynx
B1st and 2nd pharyngeal arch
CThe branchial cleft
D4th pharyngeal arch
E4th pharyngeal pouch
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