The skin of the chin is innervated by:

A. buccal nerve

B. infraorbital nerve

C. marginal mandibular nerve

D. mental nerve

E. supratrochlear nerve

Which layer of the scalp contains the superficial temporal artery?

A. layer 1

B. layer 2

C. layer 3

D. layer 4

E. layer 5

Which nerve innervates the orbicularis oculi?

A. auriculotemporal nerve

B. infraorbital nerve

C. supraorbital nerve

D. zygomatic branch of facial nerve

E. zygomaticofacial nerve

D
Most of the face is supplied with blood from the external carotid artery. Which
area is supplied by the internal carotid artery?

A. cheek

B. chin

C. forehead

D. side of the nose

E. upper lip

How does the facial nerve leave the skull?

A. foramen ovale

B. foramen rotundum

C. internal acoustic meatus

D. jugular foramen

E. stylomastoid foramen

The left side of your patient's mouth is drooping and he can't close it properly.
This is most likely due to a lesion involving:

A. CN III

B. CN V

C. CN VII

D. CN IX

E. CN XII

C
An infection of the parotid gland that is contained within the capsule could
compress:

A. external carotid artery

B. facial artery

C. facial vein

D. internal jugular vein

E. maxillary artery

The muscles of facial expression are associated with the:

A. 1st pharyngeal arch

B. 2nd pharnygeal arch

C. 3rd pharyngeal arch

D. 4th pharyngeal arch

E. 6th pharyngeal arch

The cell bodies of sensory neurons that innervate the face are located in the:

A. brainstem

B. spinal cord

C. superior cervical ganglion

D. trigeminal ganglion

E. trigeminal nucleus

A
Which nerve provides sensory innervation to the lateral aspect of the scalp?

A. auriculotemporal

B. buccal

C. facial

D. mental

E. zygomaticofacial

Which nerve travels through foramen ovale to enter the deep part of the face
(infratemporal fossa)?

A. facial nerve

B. inferior alveolar nerve

C. lingual nerve

D. mandibular nerve

E. maxillary nerve

A tumor in the infratemporal fossa is compressing the auriculotemporal nerve.

Which of the following would you most likely see in this patient?

A. loss of sensation in the skin of the chin

B. loss of sensation of the dura mater

C. loss of sensation in the external acoustic meatus

D. paralysis of the masseter

E. reduction in the production of saliva by the submandibular gland

C
After traveling through the mandibular canal, the inferior alveolar nerve becomes
the:

A. buccal nerve

B. lingual nerve

C. marginal mandibular nerve

D. maxillary nerve

E. mental nerve

Which ganglion is located within the infratemporal fossa?

A. ciliary

B. otic

C. superior cervical

D. trigeminal

To fill a cavity in a mandibular molar tooth without pain, you would need to
anesthetize the:

A. buccal branch of CN V

B. inferior alveolar nerve

C. lingual nerve

D. mental nerve

E. mylohyoid nerve

B
The main source of blood to the infratemporal fossa (deep face) is provided by
the:

A. facial artery

B. internal carotid artery

C. lingual artery

D. maxillary artery

E. superficial temporal artery

56. Cutaneous innervation of the forehead is provided by the ____ nerve: a.

Facial.
b. Infraorbital.
c. External nasal.
d. Supratrochlear.
e. Zygomaticofacial.
D

57. Loss of sensation of skin over the tip of the nose is due to injury of
_______ nerve. a. Facial.
b. Olfactory.
c. Maxillary.
d. Mandibular.
e. Ophthalmic.
E

58. The cutaneous innervation of the anterior part of the SCALP is derived
from branches of the _____ nerve: a. Facial.
b. Maxillary.
c. Ophthalmic.
d. Great auricular.
e. Lesser occipital.
C
 59. Among the nerves of the face, which one of the following is a direct
continuation of the maxillary nerve? a. Lacrimal
b. Infraorbital.
c. Supraorbital.
d. Supratrochlear.
e. Infratrochlear
B.

60. The ____ muscle compresses cheek against molar teeth: a. Risorius.
b. Mentalis.
c. Buccinator.
d. Orbicularis oris.
e. Zygomaticus major
C

61. The _____ muscle draws a smile on the face: a. Risorius.

b. Levator anguli oris.
c. Zygomaticus minor.
d. Corrugator supercilii.
e. Levator labii superioris.
C

The _______ muscle helps to produce the expression of surprise on the face:
a. Platysma.
b. Buccinator.
c. Occipitofrontalis.
d. Orbicularis oculi.
e. Corrugator supercilii.
D

63. Parasympathetic innervation to the parotid gland is provided through the

______ ganglion: a. Otic.
b. Ciliary.
c. Geniculate.
d. Submandibular.
e. Pterygopalatine.
A
 64. Sensory innervation of the parotid sheath is carried by ___ nerve: a.
Facial.
b. Vidian.
c. Maxillary.
d. Great auricular.
e. Glossopharyngeal.
D

65. Sensory innervation of the parotid gland is carried by _______ nerve: a.

Vagus.
b. Buccal.
c. Great auricular.
d. Auriculotemporal.
e. Glossopharyngeal.
D

66. The preganglionic fibers to the otic ganglion reach it through the ______
nerve: a. Vidian.
b. Deep petrosal.
c. Lesser petrosal.
d. Greater petrosal.
e. Lesser occipital.
C

67. The ________ muscle retracts the mandible: a. Masseter.

b. Temporalis.
c. Buccinator.
d. Medial pterygoid
e. Lateral pterygoid.
A

68. Medial pterygoid muscle is inserted into the medial surface of the: a.
Zygomatic bone.
b. Medial pterygoid plate.
c. Lateral pterygoid plate.
d. Ramus of the mandible.
e. Coronoid process of the mandible.
 D

69. Which one of the following muscles of mastication opens the mouth?
a. Masseter.
b. Temporalis.
c. Buccinator.
d. Medial pterygoid
e. Lateral pterygoid.
E
70. Masseter muscle is inserted into the _____ of the mandible: a. Neck.
b. Angle.
c. Mylohyoid line.
d. Coronoid process.
e. Medial surface of ramus.
B

71. Which one of the following branches of the mandibular nerve supplies
the anterior belly of Digastric muscle:
a. Buccal.
b. Masseteric.
c. Deep temporal.
d. Nerve to Mylohyoid.
e. Nerve to Lateral pterygoid.
D

72. The sensory supply of the chin is derived from the _____ nerve:
a. Buccal.
b. Lingual.
c. Meningeal.
d. Inferior alveolar.
e. Auriculotemporal.
D

73. The pterygopalatine fossa is bounded superiorly by the: a. Zygomatic

arch.
b. Greater wing of the sphenoid.
c. Posterior aspect of the maxilla.
d. Pterygoid process of the sphenoid.
e. Perpendicular plate of the palatine bone.
 74. The maxillary nerve enters the pterygopalatine fossa through ____:
a. Foramen ovale.
b. Foramen rotundum.
c. Inferior orbital fissure.
d. Pterygomaxillary fissure.
e. Sphenopalatine foramen.
A
75. The maxillary nerve is connected to the Ophthalmic nerve through the
___ nerve:
a. Ganglionic.
b. Infraorbital.
c. Inferior Alveolar.
d. Zygomatico-temporal.
e. Posterior Superior Alveolar.
D

76. The preganglionic parasympathetic root of the Pterygopalatine ganglion

is the _______ nerve:
a. Deep petrosal.
b. Lesser occipital.
c. Greater petrosal.
d. Greater occipital.
e. Superficial petrosal.
D

Clinical Case Scenario (1)

Jaafar is a 24 years old university student who was involved in a fight, presented to
the emergency room with lacerations on the side of the face over the mandible, the
patient was feeling numbness in the lower lip and chin, examination and imaging
studies revealed mandibular fracture and dislocation.
Answer the following questions:
144. Which part of the mandible participates in the formation of the
temporomandibular joint (TMJ)? a. Angle.
b. Ramus.
c. Genial tubercle.
d. Symphysis menti.
e. Condyloid process
E
 145. What is the most common type of mandibular dislocation? a. Lateral.
b. Superior.
c. Anterior.
d. Posterior.
e. Posterio-superior.
C

146. What is the most common site of fracture in the mandible? a. Body.
b. Angle.
c. Symphysis menti.
d. Coronoid process.
e. Condyloid process.
B

147. What is the most commonly injured nerve following mandibular

fracture? a. Buccal.
b. Lingual.
c. Inferior alveolar.
d. Transverse cervical.
e. Marginal mandibular
C

I. Deep investing layer of cervical fascia splits to enclose:

A. Sternocleidomastoid
B. Trapezius
C. Parotid gland
D. Omohyoid
E. All of the above
C

2. Regarding the prevertebral fascia, the following is INCORRECT:

A. Cervical nerve roots, cervical plexus, trunks of the brachial plexus & subclavian
vessels lie deep to the prevertebral fascia
B. It is pierced by the great auricular, lesser occipital, transverse cervical &
supraclavicular nerves
C. It is part of the floor of the posterior triangle
D. Accessory nerve & cervical lymph nodes lie superficial to it
E. Its lower extent reaches T3 level

3. Regarding sternocleidomastoid:
A. external jugular vein lies between its 2 heads
B. accessory nerve emerges 12 way down its posterior border
C. cervical plexus emerges at its anterior border
D. cords of the brachial plexus liedeep to its lower 12
E. its anterior border forms the anterior border of posterior triangle.
E

Physiology MCQs

27- The function of tropomyosin in skeletal muscle include:

 binding to myosin during contraction
acting as a relaxing protein at rest by covering the binding sites on actin.
c- sliding on actin to produce shortening.
d- releasing Ca++ after propagation of action potential
B

28- Contraction of skeletal muscles:

a- produces more work when the muscle contracts isometrically than when the
muscle
contracts isotonically.
b- depends on external Ca++.
c- decrease in magnitude with rapid repeated stimulation.
d- does not depend on action potential.
C
29- The motor end plate potential is produced by:
a- opening of Na+ channels.
b- opening of Na+ channels then opening of K+ channels.
c- opening of Na+ and K+ channels at the same time.
d- opening of Ca++ channels.
C

30- Nerve block is produced by all the following except:

a- local anesthetics.
b- excessive cooling.
c- deep pressure.
d- strong cat-electrotonus.
D
31- As regard neuro-muscular transmission all are true except:
a- it shows fatigue due to depletion of acetylcholine vesicles.
b- occurs from nerve to muscle i.e. one way conduction.
c- it is stimulated by succinyl choline.
d- it is blocked by botulinum toxins.
C

32- Red ( slow ) fibers are characterized by the following except:

a- contains much blood capillaries.
b- glycogen stores is low.
c- contains high concentration of myoglobin.
d- depends on anaerobic oxidation.
D
33- Neuromuscular transmission is blocked by:
a- prostigmine .
b- increase Ca++ ions.
 acetylcholine .
 d- succinylcholine.
D
34- All about the Sarcomere are true except:
 a- is the distance between myosin and actin.
 b- is the distance between two Z membranes.
 c- is the contractile unite of the muscle.
 d- shorten when the muscle contracts.
A

35- Excitability of nerve fibers:

 a- is increased by decreased temperature.
 b- is increased by decreased Na+.
 c- is decreased by decrease Ca++ ions.
 d- is completely lost by local anesthetic drugs.
D
 Which is most likely to extend the entire length of a muscle fibre?
 a) Sarcomere
 b) Myofibril
 c) Myosin filament
 d) M-line
C
 Which of the following is true about muscle structure?
 a) Myofibrils make up about 15% of the contents of a muscle fibre.
 b) Even the largest (thickest) muscle fibres would contain only about 100
myofibrils.
 c) Actin filaments are arranged so that 6 actin filaments surround each
myosin filament.
 d) Myosin filaments are about twice as thick as actin filaments.
 D
 The ends of the actin filaments are anchored (attached) to the:
 a) M-line
 b) Z-line
 c) Perimysium
 d) Sarcoplasmic reticulum
 B
 When a muscle fibre shortens, the following also shortens:
 a) Sarcomere
 b) Actin filament
 c) Myosin filament
 d) Z-line
D
 In regard to the cross-bridge (CB) power stroke, it is true that:
 a) In concentric contractions, the CB power stroke pulls the actin filament
toward the center of the sarcomere, causing sarcomere shortening.
 b) In eccentric contractions, the CB power stroke pushes the actin filament
away from the centre of the sarcomere, causing sarcomere lengthening.
 c) In isometric contractions, the CB power stroke pulls the actin filament
straight down, preventing shortening or lengthening.
 d) All of the above are true.
C
 During one cross-bridge (CB) cycle:
 a) The CB binds to troponin.
 b) ATP binds to the actin binding site.
 c) One molecule of ATP is used.
 d) The CB performs two power-strokes.
C
 In excitation-contraction coupling:
 a) The muscle action potential propagates along the sarcolemma and down
the transverse tubules.
 b) Ca  released from the sarcoplasmic reticulum binds to tropomyosin.
2+

 c) Troponin blocks binding of myosin heads to actin filaments.

 d) Relaxation occurs when Ca  is excreted from the muscle fibre.
2+

D
 The sarcoplasmic reticulum does not:
 a) Surround each myofibril.
 b) Release Ca  in response to a muscle action potential.
2+

 c) Has a Ca  "pump" in its membrane.

2+

 d) Make up about 85% of the contents of a muscle fibre.

D

The force of a tetanic contraction is greater than that of a twitch contraction because:

 a) More acetylcholine is released at the neuromuscular junction per nerve

impulse.
 b) More Ca  is released in a tetanic contraction.
2+

 c) The muscle action potentials travel faster along the transverse tubules.
 d) The muscle action potentials are smaller during a tetanic contraction.
D
 Due to shape of the force-frequency relationship, one would expect to see the
greatest change in force between frequencies of:
 a) 5 to 10 Hz (stimuli per second).
 b) 45 to 50 Hz
 c) 65 to 70 Hz
 d) 80 to 85 Hz
D
 Eccentric contractions are stronger than isometric and concentric contractions partly because,
in eccentric contractions:
 a) More muscle fibres within a muscle are activated.
 b) Within each muscle fibre, more cross-bridges are attached to actin at a
given time.
 c) Muscle fibres are conducting muscle action potentials at a higher
frequency.
 d) More ATP is used in each cross-bridge cycle.
B
 Concentric contractions are weaker than isometric and eccentric contractions partly because,
in concentric contractions:
 a) There is a smaller number of cross-bridges bound to actin at any time.
 b) There may a small decrease in the force per cross-bridge.
 c) Some attached cross-bridges may exert a "drag" effect on the actin
filament.
 d) All of the above.
D

 Athletes A and B were tested for the load-velocity relationship. A and B were found to have
the same isometric maximum (ISOmax), but A's Vmax was 50% greater than B's. The largest
difference between A and B would be in:
 a) 1 RM
 b) Velocity attained with a load equal to 90% ISO max

 c) Velocity attained with a load equal to 50% ISO max

 d) Velocity attained with a load equal to 10% ISO max

C
 The greatest peak force would be developed during which of the following maximal
contractions?
 a) Fast concentric
 b) Fast eccentric
 c) Slow concentric
 d) Slow eccentric
C
 As shortening velocity increases, concentric force decreases because:
 a) There is a progressive decrease in the number of attached cross-bridges.
 b) Cross-bridge cycles become slower.
 c) Muscle action potentials propagate more slowly.
 d) All of the above.
A
 As lengthening velocity increases, eccentric force increases because:
 a) Cross-bridge cycles become slower.
 b) There is a greater number of attached cross-bridges at a given point in
time.
 c) More ATP is used.
 d) All of the above.
C
 Which if the following is not a mechanism of stretch-shortening cycle (SSC) potentiation?
 a) High initial force level at the end of the eccentric phase
 b) Enlargement of muscle action potentials during the concentric phase
 c) Storage of elastic energy during the eccentric phase
 d) Take-up of the SEC during the eccentric phase
B
 ECC-ISO force enhancement (FE), also called stretch-induced residual force enhancement of
isometric force, has been observed in:
 a) Myofibrils
 b) Muscle fibres
 c) Whole muscles
 d) All of the above
A
 A greater magnitude of ECC-ISO FE is produced when:
 a) There is a larger increase in muscle length during the ECC phase.
 b) The speed of the ECC phase increases.
 c) There is a brief relaxation between the ECC and ISO phases.
 d) All of the above.
A
 An athlete lifts a weight and then holds it stationary; this should result in:
 a) SSC potentiation.
 b) CON-ISO force depression.
 c) ISO-CON potentiation.
 d) ECC-ISO force enhancement.
D
 CON-ISO force depression (FD):
 a) Is proportional to the amount of work (force displacement) done during
the CON.
 b) Is unaffected by the speed of the CON phase.
 c) Is most pronounced at lengths shorter than optimal length.
 d) All of the above
A
 In regard to the force-length relationship, it is true that:
 a) Total force is equal to the sum of active and passive force.
 b) Beyond resting length, passive force increases from short to long muscle
lengths.
 c) The muscle length at which maximal active force occurs is called optimal
length.
 d) All of the above are true.
D
 The decrease in active force that occurs at lengths longer than the optimal length is caused
by:
 a) Overlap of actin filaments with each other.
 b) Neural inhibition.
 c) Insufficient Ca  release.
2+

 d) Insufficient overlap of actin and myosin filaments.

A
 A strength curve (SC) differs from the active force-length relationship (FLR) in that:
 a) A SC is unaffected by changes in sarcomere length.
 b) A SC may be affected by changes in muscle moment arm, whereas a
FLR is not affected by changes in muscle moment arm.
 c) A SC can only be produced with isometric contractions, whereas a FLR
can be produced with all contraction types (isometric, concentric, eccentric).
 d) All of the above are true.
B
 The shape of a strength curve could be altered by:
 a) Training
 b) Fatigue
 c) Injury
 d) All of the above
D