A person receives a shallow knife wound just behind the sternocleidomastoid muscle and about 1 1/2 inches above the clavicle. There is an immediate numbness of the skin below the wound and over the acromion and clavicle. The nerve most likely severed was the
greater auricular lesser occipital supraclavicular suprascapular transverse cervical
Which muscle is innervated by a branch of the ansa cervicalis?
Sternocleidomastoid Platysma Sternohyoid Trapezius
The layer of encircling cervical fascia that splits to enclose sternocleidomastoid and trapezius muscles is the:
Superficial fascia Superficial layer of deep fascia Infrahyoid fascia Prevertebral fascia Visceral fascia
Which of the following is a dorsal ramus of a spinal nerve?
Supraclavicular n. Transverse cervical n. Great auricular n. Greater occipital n. Lesser occipital n.
Which of the following is true of the inferior thyroid arteries?
They arise from the external carotid arteries They cross over the superior cervical sympathetic ganglion They supply most of the anterior surface of the thyroid gland They often supply all four parathyroid glands
A 20 year old man was brought into the emergency room with a stab wound in the upper part of the neck. Although there was no major damage done, he lost sensation from the skin over the angle of the jaw. Which nerve has been cut?
Supraclavicular n. Transverse cervical n. Great auricular n. Greater occipital n. Lesser occipital n.
The triangle in which the superior branch of the ansa cervicalis separates from the hypoglossal nerve is the:
Carotid Muscular Subclavian Submental Occipital
Exploration of the tracheoesophageal groove at the level of the thyroid gland would reveal what important structure bilaterally?
Cervical sympathetic trunk Phrenic nerve Pyramidal lobe Recurrent laryngeal nerve Superior thyroid artery
A 35 year old woman was diagnosed with an adenoma of the thyroid gland. This required excision of the lower pole (left lobe) of the gland and ligation of the artery supplying that region. Which of the following nerves accompanying the artery is most likely to be damaged if the surgeon is not careful?
External branch of the superior laryngeal Internal branch of the superior laryngeal Recurrent laryngeal Vagus proper Sympathetic trunk
One of the motor components of the cervical plexus, the ansa cervicalis, innervates all of the following muscles except the:
Omohyoid Sternohyoid Sternothyroid Stylohyoid Thyrohyoid
A man has metastatic carcinoma and enlarged deep cervical lymph nodes. One of his symptoms is a hoarse voice, barely heard above a whisper. Subsequently he succumbs to the disease and at autopsy it is found that one of the enlarged nodes has put pressure on a nerve in the tracheoesophageal groove. Presumably this was the reason for the hoarse voice. What nerve was involved?
External branch of the superior laryngeal nerve Internal branch of the superior laryngeal nerve Nerve to the cricothyroid muscle Pharyngeal branch of the glossopharyngeal nerve Recurrent laryngeal branch of vagus
You are called on to do a venous catheterization to measure central venous pressure in the heart. Which muscle of the neck would provide the best area of approach to the internal jugular vein?
Anterior scalene Digastric Omohyoid Sternocleidomastoid Sternohyoid
A patient is brought into the Emergency Room in respiratory distress. It is quickly decided to create an emergency airway to restore respiration. At what level could you rapidly create an airway below the vocal cords with a minimum danger of hemorrhage?
Just above the jugular notch Just above the thyroid cartilage Just below the cricoid cartilage Just below the thyroid cartilage Through the 3rd tracheal ring
A 47-year-old woman is diagnosed as having a thyroid tumor. Surgery to remove the cancerous growth is undertaken. In which triangle of the neck will the surgeon make an incision to gain access to the gland?
Carotid Muscular Subclavian Submandibular Submental
A 50-year-old woman is brought to the operating room for a biopsy of a suspicious looking nevus (mole) which is found along the anterior border of her sternocleidomastoid muscle at about its midlength. What nerve must be locally anesthetized for the operation to proceed without pain?
Ansa cervicalis External branch of the superior laryngeal Great auricular Supraclavicular Transverse cervical
Following surgery on the upper pole of the right lobe of the thyroid gland, a patient complains of hoarseness and weakness of voice. What nerve may have been injured?
Ansa cervicalis External branch of the superior laryngeal Inferior laryngeal Internal branch of the superior laryngeal Recurrent laryngeal
These structures are all located in the superficial fascia of the neck EXCEPT
External jugular vein Platysma muscle Cervical branch of the facial nerve Omohyoid muscle Transverse cervical nerve
The superior belly of the omohyoid forms the anterior border of which cervical triangle?
Carotid Muscular Omoclavicular Posterior Submandibular
The cervical plexus innervates all of the following structures EXCEPT:
Diaphragm Omohyoid muscle Platysma Skin over thyroid cartilage Skin over clavicle
An emergency room patient presented with considerable bleeding from a shallow stab wound in the omoclavicular triangle. Which vessel was most likely cut?
Axillary vein Common carotid artery External jugular vein Inferior thyroid vein Superior thyroid artery
Which structure or area receives NO nerve fibers from the cervical plexus?
Diaphragm Skin over the angle of the mandible Skin over the external occipital protuberance Thyrohyoid muscle
A six-year-old child, whose medical history includes a rather difficult birth, has a permanently tilted head posture, with the right ear near the right shoulder and the face turned upward and to the left. Which of the following muscles was very likely damaged during birth?
Anterior scalene Omohyoid Sternocleidomastoid Trapezius Platysma
Any irritation of the diaphragm (e.g. infection, tumor) may create referred pain that seems (to the patient) to originate in the area atop the shoulder. This is due to the fact that the phrenic nerve shares spinal segments with what cutaneous nerve in the shoulder region?
Dorsal scapular Lesser occipital nerve Long thoracic nerve Supraclavicular nerve Suprascapular nerve
Which of the following statements about the cervical plexus is true?
It comprises spinal segments C1-C3 It consists solely of cutaneous nerves It consists solely of ventral rami of spinal nerves It supplies motor innervation to platysma
A muscular patient who regularly lifts weights presents with pain and weakness in his right upper limb that has been slowly developing over time. His limb is cool and there is an obvious vascular insufficiency in his upper extremity. Subsequent tests show that a large vessel passing between the anterior and middle scalene muscles is being occluded by hypertrophy (enlargement) of the muscles due to the excercise. The artery involved is the:
axillary brachial brachiocephalic subclavian suprascapular
In repairing a damaged right subclavian artery, the surgeon notices and protects a large nerve passing around to the posterior surface of the artery. This nerve, which does not encircle the subclavian on the left side, is the:
Phrenic Vagus Recurrent laryngeal Sympathetic trunk Ansa cervicalis
A stab wound just above the left clavicle, lateral to the sternocleidomastoid muscle, may be life-threatening because of the possibility of injury to the:
Brachial plexus Internal jugular vein Axillary artery Subclavian artery Thoracic duct
A 27-year-old man who is a professional weight lifter comes to his physician complaining of recent weakness in his left arm and frequent tingling in his hand and fingers during exercise sessions which subsides with rest. He is diagnosed as having vasuclar insufficiency due to scalenus anticus syndrome and as a remedy it is decided to transect the anterior scalene muscle where it inserts on the first rib. During surgery, which structure in contact with the anterior surface of the muscle must the surgeon be careful of sparing? Inferior trunk of the brachial plexus Long thoracic nerve Phrenic nerve Sympathetic trunk Vagus nerve
A 60-year-old man with a previous history of right carotid endarterectomy, comes to his physician complaining of light-headedness and dizziness whenever he uses his right hand vigorously. He is diagnosed as having subclavian steal syndrome due to an atherosclerotic plaque at the point where his subclavian artery branches from the brachiocephalic trunk. The cerebral insufficiency is the result of blood being stolen from which artery? External carotid Internal carotid Middle cerebral Thyrocervical trunk Vertebral
A first year resident attempts to insert a central venous catheter into the heart by a subclavicular approach to the subclavian vein. Following the attempt, it is noted that the patient has difficulty breathing. What nervous structure lying immediately deep to the subclavian vein, as it crosses the anterior scalene muscle, may have been injured?
External branch of the superior laryngeal nerve Phrenic nerve Recurrent laryngeal nerve Sympathetic trunk Vagus nerve
Which statement is true of the internal jugular vein?
It drains all of the thyroid gland on that side of the body It drains into the external jugular vein It is accompanied by the deep cervical chain of lymph nodes It lies deep to the prevertebral fascia It passes superficial to the sternocleidomastoid muscle
Which structure lies immediately anterior to the right anterior scalene muscle at its costal attachment?
Subclavian artery Subclavian vein Thoracic duct Thyrocervical trunk Vagus nerve
A person develops a primary tumor of the thyroid gland and, among other symptoms, drooping of the eyelid and constriction of the pupil on the right side of the eye are noted. What nerve fibers have been interrupted by the tumor?
postganglionic parasympathetic postganglionic sympathetic preganglionic parasympathetic the carotid nerve the cervical sympathetic trunk
An abscess was surgically removed from the middle of the posterior triangle on
the right side. During recovery the patient noticed that her shoulder drooped and she could no longer raise her right hand above her head to brush her hair. Which nerve has been cut?
Accessory (XI) Ansa cervicalis Facial (VII) Hypoglossal (XII) Suprascapular
A surgeon doing a deep cervical lymph node dissection may encounter these structures upon the anterior surface of the anterior scalene muscle EXCEPT:
Phrenic nerve Subclavian vein Middle trunk of the brachial plexus Transverse cervical artery Cervical part of the thoracic duct
The middle cervical sympathetic ganglion, recurrent laryngeal nerve, and parathyroid glands are all closely related with which blood vessel?
Inferior thyroid artery Inferior thyroid vein Superior thyroid artery Superior thyroid vein
During surgical procedures of the neck, structures within the carotid sheath can be retracted (pulled aside) as a unit. Which of the following structures would remain in place when the carotid sheath is retracted?
common carotid artery cervical sympathetic trunk internal jugular vein internal carotid artery vagus nerve
Which of the following nerves is derived from the dorsal primary rami of spinal nerves?
great auricular greater occipital lesser occipital phrenic supraclavicular
Which of the following hyoid muscles is an important landmark in both the anterior and posterior triangles of the neck?
geniohyoid mylohyoid omohyoid sternohyoid stylohyoid
Following thyroid surgery, it was noted that a patient frequently aspirated fluid into her lungs. Upon examination it was determined that the area of the piriform recess above the vocal fold of the larynx was numb. What nerve may have been injured?
External branch of the superior laryngeal Hypoglossal Internal branch of the superior laryngeal Lingual Recurrent laryngeal
The laryngeal muscle most responsible for stretching (elongating) the vocal ligament is the :
Posterior cricoarytenoid Lateral cricoarytenoid Thyroarytenoid Arytenoid Cricothyroid
The muscle most responsible for the abduction of the vocal folds is the :
Arytenoid Cricothyroid Lateral cricoarytenoid Posterior cricoarytenoid Thyroarytenoid
The nerve that innervates all but one muscle of larynx is the:
Glossopharyngeal nerve, pharyngeal branch Inferior laryngeal nerve Superior laryngeal nerve, external branch Superior laryngeal nerve, internal branch Thyrohyoid nerve
The vocalis muscle is most responsible for the fine control of phonation because of its attachment into the:
Arytenoid cartilage Cricoid cartilage Thyroid cartilage Vestibular ligament Vocal ligament
The constrictor muscles of the pharynx receive their motor nerve supply from the:
Glossopharyngeal nerve Hypoglossal nerve Spinal accessory nerve Sympathetic trunk Vagus nerve
Twenty-four hours following a partial thyroidectomy where the inferior thyroid artery was also ligated (tied off), the patient now spoke with a hoarse voice (whisper), and had difficulty in breathing. Which nerve was injured?
Internal branch of superior laryngeal Ansa cervicalis Ansa subclavia Recurrent laryngeal External branch of superior laryngeal
In performing a thyroidectomy, caution should be exercised when ligating (tying) the inferior thyroid artery, as it lies in a very close relationship to which nerve?
ansa cervicalis hypoglossal phrenic recurrent laryngeal vagus
A 60-year-old man has occasional blackouts and light-headedness. Studies reveal atherosclerotic plaques within the common carotid arteries and the bifurcation of the vessels. A carotid endartectomy is undertaken. Which nerve bundle running vertically within the carotid sheath must the surgeon be careful not to injure?
Accessory Cervical sympathetic trunk Glossopharyngeal Hypoglossal Vagus
A 55-year-old woman has difficulty swallowing and frequently aspirates fluids while drinking. She is diagnosed as having a skull base tumor occupying the space behind the jugular foramen. Involvement of which structure is responsible for the findings?
Ansa cervicalis Cervical sympathetic trunk Accessory nerve Hypoglossal nerve Vagus
While doing a postoperative physical on a patient who has undergone carotid endarterectomy on the right side, it was noted that the tongue deviated toward the right when the patient was asked to point the tongue outward. What nerve crossing the carotid artery must have been injured?
Glossopharyngeal Hypoglossal Inferior alveolar Lingual Vagus
Any manipulation of the superior thyroid artery must be undertaken with care not to damage its small companion nerve, the:
Cervical sympathetic trunk External branch of the superior laryngeal Inferior root of the ansa cervicalis Internal branch of the superior laryngeal Recurrent laryngeal
The carotid body is innervated by a branch of the:
Glossopharyngeal nerve Hypoglossal nerve Spinal accessory nerve Sympathetic trunk Vagus nerve