Chapter·AnatomyPharyngeal arches

Second pharyngeal arch derivativesDownloads

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1

A 10-month-old boy is brought to the clinic with a history of recurrent episodes of stridor and wheezing. His mother reports that his wheezing is exacerbated by crying, feeding, and flexion of the neck, and is relieved by extension of the neck. Occasionally he vomits after feeding. What is the most likely diagnosis?

ALaryngomalacia

BCongenital subglottic stenosis

CGastroesophageal reflux disease

DDouble aortic arch

ERecurrent viral wheeze

2

A 27-year-old man comes to the physician because of a 1-day history of right-sided facial weakness and sound intolerance. Three days ago, he hit the right side of his head in a motor vehicle collision. He neither lost consciousness nor sought medical attention. Physical examination shows drooping of the mouth on the right side. Sensation over the face is not impaired. Impedance audiometry shows an absence of the acoustic reflex in the right ear. Which of the following muscles is most likely paralyzed in this patient?

AAnterior belly of the digastric

BStylopharyngeus

CCricothyroid

DTensor tympani

EStylohyoid

3

A professional musician visits his physician after a morning concert. He complains of painless swelling in his right cheek when he plays his tuba. Physical examination of the patient reveals slight facial asymmetry due to minor swelling on the right side of the face. The skin over the swelling is smooth without any secondary changes. Palpation reveals a soft and non-tender swelling. The oral opening is normal without any trismus. Further examination reveals swelling of the right buccal mucosa extending from the first to the third molar. Bedside ultrasound shows small areas of high echogenicity consistent with pneumoparotid. Which nerve is associated with motor function to prevent air from entering the affected duct in this patient?

ACN VII – Zygomatic branch

BV3 – Mandibular nerve

CCN VII – Buccal branch

DCN VII – Marginal mandibular branch

EV2 – Maxillary nerve

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