A patient is admitted after a head injury and sinks rapidly into a coma.

An MRI scan indicates an

extradural haemorrhage because extravasated blood can be detected between the

a) skull bones and dura mater.

b) dura mater and arachnoid.
c) arachnoid and pia mater.
d) pia mater and brain surface.
A
Emissary veins connect the intracranial venous sinuses to

a) veins draining the scalp.

b) veins draining the eye.
c) the pterygoid venous plexus.
d) All of the above areas.
A
Cerebrospinal fluid circulates around the brain between the

a) skull and dura mater.

b) dura mater and arachnoid mater.
c) arachnoid and pia maters.
d) pia mater and brain surface.
C

All of the following are dural venous sinuses EXCEPT :

        A. Sigmoid sinus

        B. Frontal sinus
        C. Transverse sinus
        D. Straight sinus
        E. Cavernous sinus

Regarding the dural venous sinuses, which of the following pairs is matched
INCORRECTLY?
    A. Superior sagittal sinus : arachnoid granulations.
    B. Transverse sinus : sphenoid bone.
    C. Inferior sagittal sinus : free margin of the falx cerebri.
    D. Sigmoid sinus : jugular foramen.
    E. Cavernous sinus : middle cranial fossa.

The dural venous sinus found on the floor of the middle cranial fossa is the
a. sigmoid
b. superior petrosal
c. straight
d. cavernous
e. occipital
D
 Dura mater is divided into what portions?
o A. 

Periosteal

o B. 

Meningeal

o C. 

Arachnoid

o D. 

Border cell
B
 A subdural hematoma is between the skull and the dura mater
o A. 

True

o B. 

False
B

 Dural infoldings...
 o A. 

Are also called septa or reflections

o B. 

Consist of areas in which the periosteal portion of the dura folds inward to
separate the cranial cavity into compartments

o C. 

Form compartments which determine how displacements can occur with injury
as an expanding lesion forces areas of the brain between compartments

o D. 

Include the falx cerebri and tentorium cerebelli which are considered the primary
folds

o E. 

Includes the diaphragma sella, which is the largest septum

D
  
If a patient is complaining of a headache that affects the back of their head,
irritation of what part of the dura is likely to be involved?

o A. 

Periosteal

o B. 

The dura above the tentorium

o C. 

Infratentorial dura
B

With regards to the arachnoid mater....
o A. 

It is more collagenous than dura mater

 o B. 

It has two primary parts, the arachnoid barrier layer and the arachnoid trabeculae

o C. 

The arachnoid trabeculae help suspend the brain in the subarachnoid space

o D. 

The trabeculae help reduce the weight of the brain by about 97%

The pterygopalatine fossa communicates with ALL BUT ONE of the following:
A) Nasopharynx through the sphenopalatine foremen
B) Orbit through the inferior orbital fissure
C) Infratemporal fossa through the pterygomaxillary fissure
D) Mouth through the greater palatine canal
E) Middle cranial fossa through the foremen rotundum

The temporal fossa contains a portion of all of the following structures EXCEPT the:

 Greater wing of the sphenoid bone.

 Coronal suture.
 Lambdoid suture.
 Temporal bone
 Parietal bone
C
The temporomandibular joint:

 Is the site of articulation between the mandibular fossa of the temporal bone
and the coronoid process of the mandible
 Has an articular tubercle at its posterior margin
 Contains an articular disc that is located between two synovial cavities
 Is a fibrous joint
 Is strengthened anteriorly by the stylomandibular ligament
A

3. The lateral pterygoid muscle:

 Has an inferior head that takes origin from the medial surface of the lateral
pterygoid plate
 Has an inferior head that inserts onto the neck of the condylar process of the
mandible
 Assists in elevating the mandible
 Is innervated by a nerve that travels through the foramen rotundum
 Is located in the temporal fossa
B

4. Clamping off the maxillary artery at its origin within the parotid gland would
decrease the blood flow to which of the following structures?

 Second maxillary molar tooth

 Masseter muscle
 Cranial dura mater deep to the pterion
 Depressor anguli oris muscle
 All of the above
E

5. The otic ganglion:

 Contains neuronal cell bodies that supply parasympathetic innervation to the

parotid gland
 Is located immediately inferior to the foramen rotundum
 Is the site of synapses formed by nerve fibers that travel in the facial nerve
(VII)
 Contains neuronal cell bodies that supply general sensory innervation to the
anterior 2/3 of the tongue
 Contains neuronal cell bodies that supply parasympathetic innervation to the
glands of the lateral nasal wall
A

6. If the auriculotemporal nerve were damaged, which of the following functions

would be affected?

 Contraction of the occipital belly of the occipitofrontalis.

 The ability to produce tears in the right lacrimal gland.
 The ability to regulate secretion from the right parotid gland.
 The ability to feel pressure from skin in the region inferior to the lobule.
 The ability to feel cold on the forehead.
C

7. The muscles involved in depressing the mandible include all of the following
EXCEPT the:

 Medial pterygoid
 Lateral pterygoid
 Mylohyoid
 Digastric
 Geniohyoid
A
Which of the following is not considered one of the contents of the PT Fossa?

Pterygopalatine Ganglion

V-2

Otic Ganglion
Maxillary Artery
C OTIC GANGLION

A patient comes to your ER with a deep laceration on the side of his face. You notice
that it is in the area of the IT Fossa, which one of the following structures would not
be affected?

Pterygoid Venous Plexus

Inferior Portion of Temporalis, Medial and Lateral Pterygoids

Sphenomandibular Ligament

Branches of CN V, VII & IX

Otic Ganglion
A

Ciliary ganglion

The Maxillary Artery enters the PT Fossa from the IT Fossa from which of the
following?

Foramen Ovale

Pterygopalatine Fissure

Inferior Orbital Fissure

Sphenopalatine Foramen
D
A patient comes into your office complaining of loss of motor function during
mastication. You believe the loss of motor function is because of a nerve
block. Which nerve would most likely be affected?

VII

V-1

V-2

V-3
A

The preganglionic and postgoanglionic parasympathetic fibers innvervating

the Parotid Gland are respectively the:

Lesser Petrosal N. and Greater Temporal N.

Greater Petrosal N. and Greater Temporal N.

Lesser Petrosal N. and Auriculotemporal N.

Greater Petrosal N. and Auriculotemporal N

D.

In the temporomandibular joint, the upper joint cavity is involved in which of

the followin?

Protrusion and Elevation

Retraction Only

Elevation and Retraction

Protrusion and RetractiON

C
Which of the following are not considered one of the muslces of mastication?

Masseter

Lateral Pterygoid

Temporalis

Buccinator

Medial Pterygoid
C

A patient presents to you with a lesion in the Greater Petrosal Nerves. Which
of the following would you expect to be functioning even with the lesion?

Lacrimal Gland

Mucous Glands in Nasal Cavity

Submandibular Mucous Gland

Mucous and Salivary Glands in hard and soft palate

C

The Ophthalmic Vein drains into the Pterygoid Venous Plexus through which
of the following?

Foramen Ovale

Pterygopalatine Fissure

Inferior Orbital Fissure

Sphenopalatine Foramen
B

Q1: write down boundaries of PT fossa?

Q2: Write movements of TMJ with respect of upper and lower cavity of joint?
Q3: define truisms, what can be the reason behind that and how to fix it?
Q4: explain sympathetic and parasympathetic pathways of PT ganglion?
Q5: explain ossification of mandible and maxilla?

PHYSIOLOGY
1- The energy of muscle contraction is derived from the following except:
a- ATP.
b- muscle glycogen.
c- lactic acid.
d- Creatine phosphate
B.

2- The frequency needed to produce tetanus:

a- is increased by cooling.
b- is decreased in red muscles.
c- is increased in fatigue.
d- is decreased in the pale muscles.
B

3- Depolarization:
a- is associated with increase in membrane permeability to Na+.
b- is terminated with closure of voltage activated K+ channels.
c- is followed by muscle relaxation.
d- is caused by K+ efflux.
A

4- Action potential:
a- is a graded potential.
b- is produced by sub threshold stimulus.
c- starts with repolarization caused by outward movement of Cl-.
d- is conducted slower in thin nerve fibers.

D
5- RMP of a nerve:
a- is caused by equal distribution of ions along both sides of the membrane.
b- is caused by selective permeability of the membrane to the ions.
c- Na+ - K+ pump has no role in RMP.
d- is caused mainly by inward movement of Na+ ions.
B

6- As regard conduction of action potential in a nerve:

a- in thick myelinated nerve fibers can reach up to 120 meter / second.
b- can be increased by increase calcium.
c- can be increased by cooling.
d- is conducted with decrement
A.
Pale (fast) fiber:
a- contains much blood capillaries.
b- doesn't show fatigue.
c- contains low concentration of myoglobin.
d- depends on aerobic oxidation
C.

8- About cellular sheath ( sheath of Schwann):

a- It acts as an electric insulator around the nerve fiber.
b- It surrounds the axons of all neurons inside and outside the CNS.
c- It is responsible for the color of the white matter of the spinal cord.
d- It is essential for regeneration of the damaged verve fibers.
A

9- Myelin sheath:
a- Present in the myelinated and unmyelinated nerve fibers.
b- Formed of lipoprotein complex and acts as electric insulator.
c- It is formed of successive wrappings of the membrane of Schwann cells.
d- It is the cause of decreased conduction of nerve impulse.
B

10- Chronaxia:
a- is the minimal stimulus which produce response after relatively long time.
b- is the minimal time needed by the strong stimulus to produce response.
c- is the time required to stimulate the nerve by a minimal stimulus.
d- is the time required to stimulate the nerve by a stimulus which is double
rheobase
B.

11- During depolarization:

a- voltage activated Na+ channels open.
b- the membrane becomes impermeable to Na+.
c- when membrane potential reaches -55 m.v Na+& K+ fluxes occur at the same
time.
d- K+ ions diffuse outside.
A

12- The resting membrane potential is caused by:

a- Diffusion of K+
ions outside the nerve fibers.
b- Diffusion of Na+ ions inside the nerve fibers.
c- Opening of the chemically activated ion channels.
d- Opening of the voltage activated ion channels.
A

13- To measure resting membrane potential:

a- We use a special voltmeter or cathode ray oscilloscope (CRO). b- We put the
two electrodes outside the nerve fiber.
c- We stimulate the nerve by an effective stimulus.
d- We put the two electrodes inside the nerve fiber.
A

14- Repolarization:
a- Occurs at first gradual then becomes fast.
b- Results from closure of sodium gates and opening of potassium gates.
c- is represented by the ascending limb of the spike
.
d- is followed by appearance of response.
B

15- Continuous conduction:

a- occurs in myelinated nerve fibers.
b- occurs by jumping of charges from one node of Ranvier to another.
c- is relatively slow 0.5-2.0 meter / second.
d- occurs in the neuro-muscular junction.
A

16- Saltatory conduction:

a- occurs in unmyelinated nerve fibers.
b- may reach up to 120 meter / second.
c- occurs by jumping from one neuron to another.
d- decreases gradually with distance till it disappears.
B
18- In monophasic action potential:
a- One electrode is put inside and the other is put outside the same nerve fiber.
b- The spike is a large wave of short duration.
c- The spike is followed by positive after potential then negative after potential.
d- The ascending limb of the spike is due to K+ efflux.
B

19- Local excitatory state is characterized by the following except:

a- its magnitude is directly proportional with the intensity of the sub-minimal
stimulus.
b- does not obey all or non rule.
c- can be summated.
d- propagated without decrement
C.

20- About A fibers all are true except:

a- They have the greatest diameter.
b- They conduct impulses with the greatest velocity (10-120 met./sec)
c- They include somatic sensory and motor fibers.
d- They are very sensitive to local anesthetic drugs
D
21- In all or non rule:
a- A minimal stimulus produces a maximal response.
b- The response in a single nerve fiber increases with increase intensity of
stimulus.
c- The nerve trunk either respond maximally or not respond at all.
d- Minimal stimulus produces minimal response.
A

22- Excitation contraction coupling involves all the following except:

a- Release of Ca++ from troponin.
b- Formation of cross bridges between actin and myosin.
c- Spread of depolarization along the transverse tubules.
d- Hydrolysis of ATP to ADP.
A

23- Muscle fatigue is due to:

a- Inability of the action potential to spread over the muscle.
b- Failure of transmission in the motor nerve.
c- Failure of neuro-muscular transmission.
d- Depletion of energy stores.
A

24- An-electrotonus :
a- is a localized area of depolarization.
b- results from stimulation by effective galvanic current .
c- is associated with decreased excitability.
d- used to stimulate the nerve fibers
D

25- Nerve block is produced by:

a- Sever cooling.
b- Strong catelectrotonus.
c- Decrease Ca++ ions.
d- Increased Na+ ions
C.

26- Which of the following has the lowest conduction velocity:

a- A α fibers.
b- A β fibers.
c- B fibers.
d- C fibers. C