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NEURO ANATOMY 93

Nerves of Head and Neck

CRANIAL NERVES Afferent tongue


(SVA)
 12 Pairs: I-XII
 Numbered Anterior to Posterior General Sensory nucleus of Carry general

 Attach to inferior surface of brain Somatic trigeminal nerve sensation (pain,

 Exit brain through foramina in skull Afferent 1. Chief touch,

 I + II attach to Forebrain (cerebrum + diencephalon) (GSA) 2. Mesencephalic temperature

 III-XII attach to Brainstem (midbrain, pons, medulla) 3. Spinal from skin) and

 Only X goes beyond the head-neck proprioception


(vibration,

MORPHOLOGICAL CLASSIFICATION muscle and joint

1. Nerves which supply muscles derived from cranial sense)

myotome: III, IV, VI & XII Special 1. Vestibular nuclei Carry special
2. Nerves which supply muscles derived from Somatic 2. Cochlear nuclei sense of bearing
branchial arches: V, VII, IX, X & XI Afferent and equilibrium
3. Nerves associated with special sense: I, II & VIII (SSA)

FUNCTIONAL COLUMNS AND NUCLEI ORIGIN


Functional Cranial Nerve Origin
Nuclei Supply to
Column
Olfactory Nerve (I) Cerebrum
Motor
General 1. Oculomotor nucleus Striated muscles Optic Nerve (II) Cerebrum
Somatic 2. Trochlear nucleus of limbs and
Midbrain-Pontine
Efferent 3. Abducent nucleus body wall Oculomotor Nerve (III)
junction
(GSE) 4. Hypoglossal nucleus developing
from somites Trochlear Nerve (IV) Midbrain
Special 1. Motor nucleus of Striated muscles Trigeminal Nerve (V) Pons
Visceral trigeminal nerve arising from
Efferent 2. Motor nucleus of branchial arches Abducent/Abducens Nerve (VI) Pontine-Medulla junction
(SVE) facial nerve (face, palate,
Facial Nerve (VII) Pontine-Medulla junction
3. Nucleus ambiguous pharynx,
larynx) Vestibulo Cochlear Nerve (VIII) Pontine-Medulla junction
General 1. Edinger Westphal Preganglionic
Glossopharyngeal Nerve (IX) Medulla Oblongata
Visceral nucleus parasympatheti
Efferent 2. Lacrimatory nucleus c fibres to Vagus Nerve (X) Medulla Oblongata
(GVE) 3. Superior salivatory supply glands
nucleus and smooth Spinal Accessory Nerve (XI) Medulla Oblongata
4. Inferior salivatory muscles, cardiac
Hypoglossal Nerve (XII) Medulla Oblongata
nucleus muscles and
5. Dorsal nucleus of glands
ENTRY/EXIT
vagus
Sensory Cranial Nerve Entry/Exit
General Nucleus tractus solitarius Carry general Cribriform plate of
Visceral sensation from Olfactory Nerve (I)
Ethmoid
Afferent viscera (lung,
Optic Nerve (II) Optic Canal
(GVA) heart, upper
GIT) Oculomotor Nerve (III) Superior Orbital Fissure
Special Nucleus tractus solitarius Carry special
Trochlear Nerve (IV) Superior Orbital Fissure
Visceral sensation from

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NEURO ANATOMY 94
Nerves of Head and Neck

Trigeminal Nerve (V)


V1 – Ophthalmic division Superior Orbital Fissure
V2 – Maxillary division Foramen Rotundum
V3 – Mandibular division Foramen Ovale

Abducent Nerve (VI) Superior Orbital Fissure

Internal Auditory Meatus


Facial Nerve (VII)
& Facial Canal

Vestibulo Cochlear Nerve (VIII) Internal Auditory Meatus

Glossopharyngeal Nerve (IX) Jugular Foramen

Vagus Nerve (X) Jugular Foramen


OPTIC NERVE (II)
Spinal Accessory Nerve (XI) Jugular Foramen
 Not a peripheral nerve
Hypoglossal Nerve (XII) Hypoglossal Canal  Covered by all three meninges
 Highly vascular
 Devoid of neurilemma
INDIVIDUAL CRANIAL NERVES
 Myelinated by oligodendrocytes
OLFACTORY NERVE (I)
 First and Shortest nerve
Measurements
 Contains only 2 orders of neurons
 Total length: 4 cm
 Only sensation which is not relayed in thalamus
 Intraorbital part: 2.5 cm
 Canalicular part: 0.5 cm
Type Origin Function Course
 Intracranial part: 1 cm
Bipolar
Central axons
olfactory
project to the Type Origin Function Course
neurons (in
Smell olfactory bulb via  Central axons
SVA olfactory
(olfaction) the cribriform converge at the
epithelium in
plate of the optic disk and
roof of nasal
ethmoid bone form the optic
cavity)
Retinal nerve, which
SSA ganglion Vision enters the skull via
Applied Anatomy
cells the optic canal
 Nerve damage results in anosmia, loss of olfactory
 Optic nerve axons
sensation (e.g., ethmoid bone fracture).
terminate in the
 Olfactory epithelium is capable of regeneration
lateral geniculate
after injury
bodies

Applied Anatomy
 When it is transected, ipsilateral blindness and loss
of direct pupillary light reflex results
 When subjected to increased intracranial pressure
(e.g., tumor), papilledema, a choked optic disk
results.
 When it is constricted, optic atrophy (i.e., axonal
degeneration) results

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NEURO ANATOMY 95
Nerves of Head and Neck

 Oculomotor palsy
 Lateral squint
 Ptosis
 Dilated pupil
 Loss of accommodation
 Weber’s syndrome
 Ipsilateral oculomotor palsy
 Contralateral hemiplegia

TROCHLEAR NERVE (IV)


OCULOMOTOR NERVE (III)  Slender of all cranial nerves
 Purely motor nerve that moves the eye, constricts  Only cranial nerve emerging from dorsal aspect of
the pupil, accommodates, and converges brain
 Supplies all Extra Ocular Muscles EXCEPT Superior  Only peripheral nerve which undergoes complete
Oblique and Lateral Rectus decussation with the nerve of the opposite side
 Through Ciliary ganglion, supplies Sphincter before emerging from brain stem
Pupillae and Ciliaris
Type Origin Function
Type Origin Function Trochlear nucleus
GSE Superior Oblique
Accessory (caudal midbrain)
Oculomotor Sphincter Pupillae,
GVE Applied Anatomy
Nucleus (Rostral Ciliaris
Midbrain)  Trochlear Nerve Palsy
Superior Medial Recti  Extorted and elevated eye
Inferior Medial Recti
Oculomotor Nucleus Medial Recti
GSE
(Rostral Midbrain) Inferior Oblique
Levator Palpebrae
Superioris

Applied Anatomy
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NEURO ANATOMY 96
Nerves of Head and Neck

Nerve Branches Distribution


Upper lid
Supraorbital nerve Frontalis
Scalp
Frontal Nerve
Conjunctiva
Supratrochlear nerve Upper Lid
Forehead
Receives branch from Lacrimal gland
Lacrimal
the zygomatic nerve of Conjunctiva
Nerve
the Maxillary Upper lid
Anterior Ethmoid Frontal, anterior,
nerve ethmoid sinuses
Branches to Ciliary Anterior septum
ganglion Nasal wall
TRIGEMINAL NERVE (V) Nasociliary Posterior Ethmoid Cornea
 A mixed nerve Nerve nerve Iris
 Trigeminal nerve is so called because of its three Ciliary body
main divisions i.e. Ophthalmic, Maxillary & Posterior ethmoid
2-3 long Ciliary nerves
Mandibular nerves sphenoid sinuses
 The largest of the cranial nerves Eye
 The nerve of the First Pharyngeal Arch
(mandibular) Maxillary Division Branches and Distribution
 Contains first-order sensory neurons in the Nerve Branches Distribution
trigeminal ganglion and in the mesencephalic
Middle Meningeal Dura of Middle
nucleus XXX
Nerve Cranial Fossa
 Contains motor neurons in the trigeminal motor
nucleus of the rostral pons Zygomatico-
Forehead
Zygomatic Nerve temporal
Cheek
Type Origin Function Zygomatico-facial
Muscles of Mastication Greater Palatine Hard Palate
Tensor Tympani Lesser Palatine Soft Palate
Ganglionic
Trigeminal motor Anterior Belly of The Nasal Cavity
SVE Branches Nasopalatine
nucleus (mid pons) Digastric Hard Palate
Mylohyoid Nasal branches Nasal Cavity
Tensor Palati Posterior Superior
Tactile, pain, and XXX Maxillary Teeth
Trigeminal ganglion Alveolar Nerve
thermal sensation from Lower Eyelids
and mesencephalic
GSE the face; the oral and XXX Nose
nucleus CN V (rostal
nasal cavities and the Upper Lip
pons and midbrain)
supra tentorial dura Infraorbital Nerve Anterior Superior
Maxillary Teeth
Alveolar Nerve
Divisions Middle Superior
1. V1 – Ophthalmic division Maxillary Teeth
Alveolar Nerve
2. V2 – Maxillary division
3. V3 – Mandibular division Mandibular Division Branches and Distribution
Nerve Branches Distribution
Branches
Meningeal Dura of Middle
Ophthalmic Division Branches and Distribution Main Trunk
Branch/Nervus Cranial Fossa

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NEURO ANATOMY 97
Nerves of Head and Neck

Spinosus
Type Origin Function
Medial Pterygoid
Abducent nucleus
Nerve to Medial Tensor Veli GSE Lateral rectus
(caudal pons)
Pterygoid Palatini
Tensor Tympani
Applied Anatomy
Labial surface of
 Convergent squint because of the unopposed
Buccal Nerve Gingiva of Molars
activity of medial rectus
and Premolars
 Inability to abduct the eye
Masseteric Nerve Masseter
Anterior Trunk  Diplopia (double vision) with maximum separation
Deep Temporal
Temporalis of 2 images while looking toward the paralyzed
Nerves
side
Nerve to Lateral
Lateral Pterygoid
Pterygoid
Auriculotemporal
Nerve
Anterior 2/3rd of
Tongue
Lingual Nerve
Floor of the
Mouth
Posterior Trunk
Mylohyoid
Branch to
Inferior Alveolar Mylohyoid
Nerve Muscle
Mental Branch to FACIAL NERVE (VII)
Chin, Lower Lip  Mixed nerve
 Motor root
Applied Anatomy  Sensory root / Nervus Intermedius
 Referred to as Facial Nerve as it supplies the
muscles of facial expression
 It’s the most regularly paralyzed of all the
peripheral nerves of the body

Type Origin Function


Lacrimal gland (via
pterygopalatine ganglion)
Superior salivatory
Submandibular and
GVE nucleus (caudal
Sublingual glands (via
pons)
submandibular ganglion)

Facial motor Muscles of facial


SVE nucleus (caudal expression
pons) Stapedius
Geniculate
Tactile sensation to skin
GSE ganglion (temporal
ABDUCENT NERVE (VI) of ear
bone)
 A pure GSE nerve that innervates the lateral rectus,
Geniculate Taste sensation from the
which abducts the eye SVA
ganglion anterior two-thirds of
 Also, termed fan’s nerve

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NEURO ANATOMY 98
Nerves of Head and Neck

tongue (via chorda Transverse Cervical Cutaneous


Neck
tympani) Nerve

Course Applied Anatomy


 Intracranial: through the cranial cavity, and the 1. Flaccid paralysis of the muscles of facial expression
cranium itself (upper and lower face)
 Extracranial: outside the cranium, through the face 2. Loss of the corneal (blink) reflex (efferent limb), which
and neck may lead to corneal ulceration (keratitis paralytica)
3. Loss of taste (Ageusia) from the anterior two-thirds of
Branches the tongue
Anatomical 4. Hyperacusis (increased acuity to sounds), due to
Branches Distribution
Region stapedius paralysis
Mucous glands 5. Bell’s palsy
Greater Petrosal
Lacrimal gland  Caused by trauma to the nerve within the facial
canal.
Nerve to Stapedius Stapedius muscle
In Facial  A lower motor neuron (LMN) lesion with
Canal Anterior 2/3rd of
paralysis of all muscles of facial expression.
tongue
Chorda Tympani 6. Bell phenomenon
Submandibular and
 Normally seen in about 75% of population
Sublingual glands
 Occurs when trying to close the eyes—the
Muscles around Ear affected eye looks up and out
Occipital part of the  Observable because of failure of orbicularis
Posterior Auricular
At Occipitofrontalis oculi to close eyelids
Stylomastoid muscle 7. Central facial palsy (supranuclear palsy)
Foramen Posterior belly of Digastric – Posterior  Results from transection of corticobulbar fibers
Digastric Belly in the internal capsule
Stylohyoid Stylohyoid muscle  Results in contralateral facial weakness below
Frontalis the orbit
Temporal Orbicularis Oculi  An upper motor neuron (UMN) lesion
Corrugator Supercilii affecting the muscles of the lower face
Zygomatic Orbicularis Oculi 8. Crocodile tears syndrome (lacrimation during eating)
Orbicularis Oris  Caused by a facial nerve lesion proximal to the
On the Face
Buccal Buccinator geniculate ganglion
Zygomaticus  Regenerating preganglionic salivatory fibers are
Marginal misdirected to the pterygopalatine ganglion, which
Mentalis muscle
Mandibular projects to the lacrimal gland
Cervical Platysma

Branches of Communication

Area Communication

Internal Acoustic Meatus VIII cranial nerve


Pterygopalatine ganglion and
Geniculate ganglion
Otic ganglion
Facial canal Auricular branch of Vagus
Below Stylomastoid IX, X, Auriculotemporal Nerve
Foramen
Behind Ear Lesser Occipital nerve
Face Trigeminal Nerve
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NEURO ANATOMY 99
Nerves of Head and Neck

Auditory tube
VESTIBULO COCHLEAR NERVE (VIII) Carotid sinus
 A pure SSA nerve Carotid body
 Maintains balance and mediates hearing Inferior (petrosal)
Taste from posterior third
 Consists of two functional divisions: Vestibular SVA ganglion (in jugular
of the tongue
Nerve and the Cochlear Nerve foramen)

Type Origin Function Branches


Equilibrium Branch Distribution
SSA Vestibular ganglion
(innervates hair cells of Tympanic branch Otic Ganglion
(Vestibular (internal auditory
semicircular ducts, (Jacobson’s nerve) Parotid Gland
Nerve) meatus)
saccule, and utricle) Carotid nerve (nerve of Carotid sinus
Spiral ganglion Hearing (innervates Herring) Carotid body
Cochlear
(modiolus of hair cells of the organ Pharyngeal Pharyngeal plexus
Nerve
temporal bone) of Corti) Muscular
Tonsillar
Lingual

Applied Anatomy
1. Loss of the gag (pharyngeal) reflex (interruption of
afferent limb)
2. Loss of the carotid sinus reflex (interruption of the
sinus nerve)
3. Loss of taste from the posterior third of the tongue
4. Glossopharyngeal neuralgia

GLOSSOPHARYNGEAL NERVE (IX)


 A mixed nerve – mostly Sensory
 It derives its name from the truth that it gives
sensory innervation to the tongue and pharynx

Type Origin Function


Inferior salivatory
Parotid gland (via the otic
GVE nucleus (rostral
ganglion)
medulla)
Nucleus
SVE ambiguous Stylopharyngeus
(rostral medulla) VAGUS NERVE (X)
Superior ganglion Tactile sensation to  A mixed nerve
GSA  Mediates phonation, swallowing (with CN IX and
(jugular foramen) middle ear cavity
Tactile sensation to CN XII), elevation of the palate, and taste
Inferior (petrosal)  Innervates viscera of the neck, thorax, and abdomen
posterior third of tongue
GVA ganglion (in jugular  Also called as Wandering Nerve
Pharynx
foramen)
Middle ear

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NEURO ANATOMY 100
Nerves of Head and Neck

Type Origin Function Cardiac Deep cardiac plexus


Viscera of the thoracic Trunk Right Recurrent
and abdominal cavities Laryngeal
Dorsal motor nucleus
GVE to the mid-transverse Left Recurrent
of CN X (medulla) Thorax
colon [via terminal Laryngeal
(mural) ganglia] Gastric
Nucleus ambiguous Muscles of the larynx Abdomen Hepatic
SVE
(mid-medulla) and pharynx Celiac
Superior ganglion Tactile sensation to the
GSA
(jugular foramen) external ear Applied Anatomy
Mucous membranes of  Ipsilateral paralysis of the soft palate, pharynx, and
the pharynx, larynx, larynx leading to dysphonia (hoarseness), dyspnea,
Inferior (nodose)
esophagus, trachea, and dysarthria, and dysphagia
GVA ganglion (in jugular
thoracic and abdominal  Loss of the gag (palatal) reflex (efferent limb)
foramen)
viscera to the mid-  Anesthesia of the pharynx and larynx, leading to
transverse colon unilateral loss of the cough reflex
Inferior (nodose)
Taste from the
SVA ganglion (in jugular
epiglottis
foramen)

Branches
Anatomical
Branches Distribution
Region
Neck

Dura of posterior
Meningeal
cranial fossa
Concha and root of
auricle
Superior
Posterior half of
Ganglion
Auricular external auditory
meatus
Outer surface of
tympanic membrane
Pharyngeal plexus
Muscles of Pharynx
Pharyngeal and Soft Palate
(except Tensor Veli
Palatini) SPINAL ACCESSORY NERVE (XI)
 Entirely motor
Superior Laryngeal
 Has 2 roots – Cranial and Spinal
Inferior Cricothyroid
 Cranial root is accessory to the Vagus and its fibres
Ganglion External Laryngeal Inferior Constrictor
are dispersed via the Vagus nerve
Pharyngeal Plexus
 Spinal root has a separate course and is normally
Mucous membrane of
regarded as Spinal Accessory nerve, or merely as
Internal Laryngeal larynx upto vocal
Accessory nerve
cords
 supplies Sternocleidomastoid and Trapezius
Carotid body
Carotid muscles
Carotid sinus

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NEURO ANATOMY 101
Nerves of Head and Neck

Type Origin Function Nerve to Thyrohyoid Thyrohyoid muscle


Anterior horn Sternocleidomastoid Nerve to Geniohyoid Geniohyoid muscle
SVE
neurons C1–C6 and Trapezius All intrinsic and extrinsic
Muscular branches to
muscles of the tongue except
Tongue
Applied Anatomy Palatoglossus
1. Paralysis of the Sternocleidomastoid muscle
 Results in difficulty in turning the head to the Applied Anatomy
side opposite the lesion  When it is transected, hemiparalysis of the tongue
2. Paralysis of the Trapezius muscle results. The tongue points toward the weak side
 Results in a shoulder droop due to the unopposed action of the opposite
 Results in the inability to shrug the ipsilateral Genioglossus upon protrusion
shoulder

HYPOGLOSSAL NERVE (XII)


 A pure GSE nerve
 Mediates tongue movement
 Represents fusion of ventral roots of 4 pre-cervical
nerves IMPORTANT CRANIAL NERVE REFLEXES
 It is spinal in behavior but cranial in outlook
Reflex Afferent Nerve Efferent Nerve

Type Origin Function Corneal Ophthalmic Facial


Intrinsic and extrinsic
Hypoglossal nucleus Conjunctival Ophthalmic Facial
GSE muscles of the tongue
(medulla)
(except the Palatoglossus) Lacrimation Ophthalmic Facial

Gag Glossopharyngeal Vagus


Branches
Branch Distribution Jaw jerk Mandibular Mandibular
Meningeal Posterior cranial fossa
Carotid sinus Glossopharyngeal Vagus
Omohyoid
Descending branch:
Sternohyoid
Containing C1 fibers
Sternothyroid

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NEURO ANATOMY 102
Nerves of Head and Neck

Mcq’s by cranial nerves containing special viscera


efferent nucleus.
- So 5th (masticatory nucleus), 7th (facial
CRANIAL NERVES
nucleus), 9, 10, 11th (nucleus ambiguus) and
FUNCTIONAL COLUMNS AND NUCLEI
12th cranial nerves (spinal accessory nucleus)
1. Mesencephalic nucleus is responsible for receiving
have special visceral component, where as
A. Pain sensation
cranial nerves responsible for eye and tongue
B. Pressure sensation
movements i.e., 3rd, 4th, 6th and 12th
C. Proprioception
(hypoglossal nucleus) have general somatic
D. Temperature sensation
efferent component.
Ref: Snell’s Clinical Neuroanatomy,
C - In the same way peripheral nerves supplying
5/e, p. 341
skeletal muscles (eg musculocutaneous nerve
supplying biceps brachi muscle) also possess
2. Following cranial nerve nuclei are present in the pons
GSE component.
at the level of facial colliculus EXCEPT
7th, 9th, 10th cranial nerves end in nucleus trachus solitaries.
A. Facial nerve nucleus
B. Abducens nerve nucleus
5. Which of the following nuclei belongs to the
C. Nucleus of spinal tract of trigeminal nerve
general visceral efferent column-AIIMS 2004
D. Pontine nuclei
A. Facial nerve nucleus
Ref: Essentials of Human Anatomy,
C B. Trigeminal nerve nucleus
A.K Datta vol 4, 3/e, p. 132
C. Dorsal nucleus of vagus
D. Nucleus ambiguous
3. Nucleus in brain common to IX,X and XI cranial
Ans:- C. i.e. Dorsal nucleus of vagus
nerves:-Delhi 92, Jipmer 03, DNB 05
A. Nucleus solitaries
6. Following nerves cross the ICA in their course in the
B. Nucleus ambiguous
neck;
C. Dentate nucleus
A. IX, X, XII nerves
D. Red nucleus
B. X, XI, XII nerves
Ans:- B i.e. Nucleus ambiguous
C. IX, X, XI nerves
D. IX, X, ansa cervicalis
4. Seventh, Ninth and Tenth cranial nerves end in-
Jipmer 92 B Ref: Gray’s Anatomy 39/e, p.547
A. Nucleus Tractus solitaries
B. Nucleus Ambiguous 7. Nucleus ambiguous contributes fibres to the following
C. Dorsal Nucleus of vagus cranial nerves EXCEPT
D. Long and of V nerve A. Facial
Ans:- A i.e. Nucleus tractus solitaries B. Glossopharyngeal
Ref:- Snell Neuroanatomy 6/e p- 340, 345, 346, IBS C. Vagus
neuroanatomy 7/c p - 106-109 , Gray's 39/e p- 332; D. Accessory
BDC 4/e vol 111 p. 332, 335
A Gray’s Anatomy 39/e, p. 1021
Explanation:-
- Dorsal nucleus of vagus, Edlinger westphal
nueleus, & salivatory (superior & inferior) 8. Nucleus of tractus solitarius is connected with the
nucleus lie in General visceral efferent column following cranial nerves EXCEPT
- All the skeletal muscles (except for those A. Facial nerve
derived from branchial arch) are supplied by B. Glossopharyngeal nerve
nerves containing general somatic efferent C. Vagus nerve
nucleus. Branchial arch muscles are supplied D. Accessory nerve

D Essentials of Human Anatomy, 3/e,

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Nerves of Head and Neck

A.K Datta vol 4, p254, 258, 259, 262 - Cranial nerves 5 & 6 are related to apex of
petrous bone
- Only 1st & 2nd cranial nerves do not arise from
9. The term “archistriatum” is applied to
brain stem and so do not pass through
A. Caudate nucleus
posterior-cranial fossa. And all other C.N (i.e
B. Putamen
3rd to 12th) pass through posterior cranial fossa.
C. Globus pallidus
- Trochlear (4th) nerve is the only cranial nerve to
D. Amygdaloid nucleus
emerge dorsally from the brain stem and has
Essentials of Human Anatomy, 3/e,
D longest intra cranial course and most slender
A.K Datta vol 2, p. 78
cranial nerve (in terms of axons it contains).
- Abducent (6th) is one of the commonest
10. Following are the cranial nerve nuclei in the midbrain involved nerve in raised intracranial tension
EXCEPT because of its long course through the cistern
A. Occulomotor nerve nucleus points and sharp bends of betrous temporal
B. Trochlear nerve nucleus bone.
C. Motor nucleus of trigeminal nerve - Intracranial aneurysm commonly present with
D. Mesencephalic nucleus of trigeminal nerve either occulomotor (3rd) or abducent (6th) nerve
C Gray’s Anatomy 38/e, p. 1069 palsy
- Trigeminal (5th) is the largest cranial nerve.

11. The term “paleostriatum” is applied to: Vagus nerve

A. Caudate nucleus - Vagus nerve (10th) has the most extensive

B. Globus pallidus distribution of all the cranial nerve. Except

C. Putamen vagus all cranial nerves are confined to head

D. Amygdaloid nucleus and neck.


- Olfactory hallucinations are seen in uncinate
Essentials of Human Anatomy, 3/e,
B fits of temproal lobe epilepsy.
A.K Datta vol 2, p.76
- Facial (7th) nerve is the most frequently
paralyzed of all cranial nerve. Facial nerve has
12. Following is the cranial nerve nucleus in the midbrain
longest intraosseous course.
at the level of the superior colliculus
- 1, 2, 8 (i.e olfactory, optic, vestibulochlear)
A. Motor nucleus of trigeminal nerve
nerves are pure sensory.
B. Sensory nucleus of trigeminal nerve
- 3, 4, 6, 11, 12 (occulomotor, trochlear, abducent,
C. Motor nucleus of occulomotor nerve
accessory and hypoglossal) are pure motor and
D. Motor nucleus of Trochlear nerve
remaining are mixed.
Essentials of Human Anatomy, 3/e,
C - Olfactory (1) nerve is the only nerve that
A.K Datta vol 4, p.141
projects directly to cerebral cortex; optic nerve
terminates in thalamus while other are
13. Cranial nerve related to apex to the petrous temporal
attached to brain stem. 3rd 4th nerve attach to
bone
midbrain; 5th to pons; 6th, 7th, 8th nerve to
A. VIII
junction between pons and medulla; and 9th,
B. VII
10th, 11th, 12th nerve attach to medulla.
C. V
Olfactory nerve is shortest cranial nerve.
D. IX
Ans:- C i.e. VI; D i.e. V
14. Which of the following cranial nerves present in the
Ref:- Keith Moore 4/e p 1093; Snell’s 7/e p
posterior fossa
801;903;908; Harrison 16/e p 2437; Gray’s students
A. 3rd to 12th
1/e p 777-778, 783, 801-805,903,908
B. 4th to 12th
Explanation:-
C. 5th to 12th
D. 6th to 12th
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Ans:-A i.e. 3rd to 12th 19. 7th, 9th, 10th cranial nerves ends in
A. Nuclesus tractus solitairius
15. Site of lesion affecting V,VI & VII cranial nerve B. Nucleus ambiguous
A. Midbrain C. Dorsal nucleus of vagus
B. Pons D. Long tract of trigeminal nerve.
C. Medulla
D. C-P angle A Ref: Gray’s Anatomy 38/e, p. 1251
Ans:-D i.e. C-P angle
Ref:- P.L Dhingra 3/e p-143-45
20. Following cranial nerve nucleus is present at the site
Explanation:-
of facial colliculus
- 3rd and 4th cranial nerve attach to mid brain; 5th
A. Facial
c.n to pons; 6th, 7th and 8th to junction between
B. Abducens
pons and medulla; 9th, 10th, 11th, & 12th attach
C. Sensory nucleus of trigeminal nerve
to medulla.
D. Motor nucleus of trigeminal nerve
- Acoustic neuroma is most common
Essentials of Human Anatomy, 3/e,
cerebellopontine angle tumor. 5th nerve is the B
A.K Datta vol 4, p. 132
earliest nerve to be involved. f/b 8th,9th,10th,6th
21. Superior and inferior salivatory nuclei have the
,7th etc.
following functional component
A. Special visceral afferent
16. Auditory transmission is via
B. General visceral afferent
A. Lateral lemniscus
C. Special visceral efferent
B. Medial lemniscus
D. General visceral efferent
C. Lateral geniculate body
Essentials of Human Anatomy, 3/e,
D. Frontal cortex D
A.K Datta vol 4, p.253
Ans:- A i.e. Lateral leminiscus

22. Following is true about nucleus ambiguous except


17. Trapezoid body is associated with
A. Its functional component is special visceral efferent
A. Auditory pathway
B. It is situated in pons at the level of facial colliculus
B. Visual pathway
C. It is connected with the ninth, tenth and eleventh
C. Pyramidal pathway
cranial nerves
D. Gustatory pathway
D. It is involved in the lateral medullary syndrome
E. Extra- pyramidal pathway
Ans:- A i.e., Auditory pathway
Snell’s Clinical Neuroanatomy, 5/e, p.
B
190
18. Auditory pathway passes through
A. Medial geniculate body
23. Following is true about nucleus of tractus solitarieus
B. Lateral geniculate body
except
C. Reciculate formation
A. It is situated in the medulla oblongata
D. Cerebellar fornix
B. Its functional component is special visceral afferent
Ans:- A. i.e. Medial Geniculate body
C. Through its connections with the reticular
Explanation:-
formation, it has reflex control of cardiovascular
- Medial geniculate body is related to auditory
and respiratory function
pathway where as Lateral geniculate body is
D. It receives afferent fibres from eleventh cranial
related to pathway
nerve
- Trapezoid body is related to auditory pathway
Inderbir Singh, Human Embryology,
Auditory pathway is : Superior olivary nucleus —> Lateral C
8/e, p. 279
lemininscus —> Inferior colliculus & Inferior Medial
geniculate body (Mnemonic - "SLIM")

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24. Mesencephalic nucleus of trigeminal nerve has C. Olfactory bulb


following functional component? D. Secondary olfactory area
A. General somatic afferent A Ref: Gray’s Anatomy 38/e, p . 1634
B. Special visceral afferent
C. General visceral afferent
3. The olfactory nerve pierces the
D. Special visceral efferent
A. Cribriform plate of ethmoid
Inderbir Singh, Human Embryology,
A B. Anterior part of root of cavernous sinus
8/e, p. 279
C. Posterior part of root of cavernous sinus
D. A and B
25. Efferent fibres of Amygdaloid nucleus are called as
A. Lamina terminalis A Ref: Gray’s Anatomy 38/e, p . 1319
B. Stria terminalis
C. Stria medullaris 4. Trauma to 1st cranial nerve results in
D. Alvenus A. Anosmia
Essentials of Human Anatomy, 3/e, B. Aphagia
B
A.K Datta vol 4, p.88 C. Paresis
D. A and C
26. Following cranial nerve nucleus is present in the
A Ref: Gray’s Anatomy 38/e, p . 1319
midbrain at the level of inferior colliculus
A. Occulomotor
B. Trochlear
C. Abducens
D. Facial OPTIC NERVE (II)

Ref: Essentials of Human Anatomy,


B 1. The optic nerve exits the eye through which the
3/e, A.K Datta vol 4, p.139-140 fig 7.13
following structures
A. Lens
27. V and VII nerves are attached in
B. Iris
A. Medulla
C. Cornea
B. Pons
D. Optic disc
C. Midbrain
Ref: Essentials of Human Anatomy,
D. A and C
D A.K Datta, 3/e, vol 2, Head and Neck,
B Gray’s Anatomy 39/e, p. 327
p. 231

2. Optic nerve is made up of axons of cells in the


INDIVIDUAL CRANIAL NERVES A. Amacrine cell layer of retina
OLFACTORY NERVE (I) B. Bipolar cell layer of retina
1. The cells of olfactory nerve are C. Ganglionic layer of the retina
A. Unipolar neurons D. Horizontal cell layer of retina
B. Bipolar neurons C Ref: Gray’s Anatomy 38/e, p . 1225
C. Multipolar neurons
D. Psuedounipolar neurons
3. The entire optic nerve is enclosed in
B Ref: Gray’s Anatomy 39/e, p . 1634 A. Dura mater
B. Dura and arachnoid mater
2. The olfactory cells or cells of primary neurons lie in C. All the three meningeal layers
the D. Has no meningeal covering
A. Olfactory part of nasal mucosa C Ref: Gray’s Anatomy 38/e, p . 1226
B. Primary olfactory cortex

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4. The ciliary ganglion is present between 2. The occulomotor nerve enters the orbit through
A. The medial rectus and the optic nerve A. Lateral part of superior orbital fissure
B. The lateral rectus and the optic nerve B. Middle part of the superior orbital fissure
C. The optic nerve and ethmoid nerve C. Sheath of optic nerve
D. The medial rectus and the ethmoid plate D. Inferior orbital fissure

B Ref: Gray’s Anatomy 38/e, p . 1226 B Ref: Gray’s Anatomy 38/e, p .1228

5. The optic nerve and the retina are direct extension of 3. The ganglion which is associated with the
the brain and when cut, cannot regenerate occulomotor nerve is
A. Both the statements are false A. Optic ganglion
B. First statement is true and the second is false B. Ciliary ganglion
C. First statement is true but when the cut ends are in C. Superior cervical ganglion
approximation they can regenerate D. None of the above
D. Both the statements are true B Ref: Gray’s Anatomy 38/e, p . 1224
D Ref: Gray’s Anatomy 38/e, p . 1228

4. True about occulumotor nerve are all except


6. Which of the bones lodge the optic nerves? A. Carries parasympathetic fibres
A. Greater wing of sphenoid B. Causes constriction of pupils
B. Lesser wing of sphenoid C. Supplies inferior oblique muscle
C. Orbital plate of frontal bone D. Passes through inferior orbital fissure
D. Junction of orbital plate of maxillary and frontal D Ref: Gray’s Anatomy 39/e, p. 698
bones

B Ref: Gray’s Anatomy 39/e, p 721-22 5. Most common nerve involved in an intracranial
aneurysm is-DNB 04, AI 96
A. Trochlear
7. In cases of the right optic nerve injury, the light reflex
B. VII
A. Would be present on left side when light is thrown
C. VIII
on left side
D. Oculomotor
B. Would be present on right side when light is
Ans:- D i.e. Occulomotor nerve
thrown on the left side
Explanation:-
C. Would be present on left side but absent on right
Intra cranial aneurysm commonly presents with
side when light thrown on right side.
either an occulomotor (IIIrd)or abducent (VIth)
D. A and B
nerve palsy.
Ref: Snell’s Clinical Neuroanatomy,
D
5/e, p. 385
6. Most common nerve involved in an intracranial
aneurysm is
A. Trochlear
B. VII
OCULOMOTOR NERVE (III)
C. VIII
1. Which of the following nerves pierces the posterior
D. Occulomotor
part of roof of the cavernous sinus?
Ans:-D i.e. Occulomotor
A. Optic nerve
B. Trigeminal nerve
7. Superior rectus is supplied by which cranial nerve
C. Occulomotor nerve
A. Superior division of 3rd nerve
D. Olfactory nerve
B. Abducent nerve
C Ref: Gray’s Anatomy 38/e, p .1228 C. Trochlear nerve

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Ans:- A. i.e. Superior division of 3rd nerve TROCHLEAR NERVE (IV)


Ref:- BDC 4/e Vol 111 -107
Explanation:- 1. The cranial nerve with the longest intracranial course –
Superior rectus & LPS are supplied by superior UPSC 93, PGI 96, DNB 97
division of occulomotor nerve. A. Optic
B. Abducent
C. Trigeminal
8. Paralysis to which nerve would cause diplopia on D. Oculomotor
looking downwards E. Trochlear
A. Temporal branch of facial nerve Ans:- E i.e., Trochlear
B. Zygomatic branch of facial nerve 2. The smallest cranial nerve is the-DNB 02, AMU 02
C. Occulomotor nerve A. Olfactory
D. Nasociliary nerve B. Oculomotor
Ref: Snell’s Clinical Neuroanatomy, C. Trochlear
C
5/e, p . 359 D. Accessory
Ans:- C i.e. Trochlear
9. True about occlumotor nerve are all EXCEPT 3. Which of the cranial nerve decussate with in the brain
E. Carries parasympathetic fibres –Nimhans 01, DNB 02, WB 03
F. Causes constriction of pupils A. Trochlear
G. Supplies inferior oblique muscle B. Optic
H. Passes through inferior orbital fissure C. Oculomotor
D. Trigeminal
D Ref: Gray’s Anatomy 39/e, p. 698
Ans:- A i.e., Trochlear
4. Superior oblique muscle is supplied by-UPSC 95,
Kerala 98, DNB 05
10. Occulomotor nerve passes through A. Occulomotor nerve
A. Foramen rotundum B. Trochlear nerve
B. Superior orbital fissure C. Abducent nerve
C. Inferior orbital fissure D. Trigeminal nerve
D. Foramen ovale Ans:- B i.e. Trochlear
B Ref: Gray’s Anatomy 39/e, p.643
5. Cranial nerve which emerges from dorsal surface of

11. Among the following cranial nerves, the pure sensory brain-AI 2000, UP 03

nerve includes all EXCEPT A. II

A. I B. IV

B. II C. VI

C. III D. VII

D. VIII Ans:- B i.e. Trochlear Nerve i.e. lVth C.N.


Ref:- Keith Moore Clinical Oriented Anatomy 4/e
Ref: Essentials of Human Anatomy,
C p.1093
A.K Datta vol 2, 3/e, p. 172
Explanation:-
Nerve Feature
12. Paralysis of upper eyelid is due to paralysis of:
A. III Throchlear (4th) Emerge dorsally from the brain

B. IV stem

C. V Longest Intracranial course

D. VII
Trigeminal (5th) Largest cranial nerve
A Ref: Gray’s Anatomy 39/e, p, 691
Vagus (10th) Most extensive distribution

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Facial (7th) Most commonly paralyzed D. The fibres of both nerves decussate completely,
Facial (7th) Longest intraosseous course anterior to the cerebral aqueduct in the midbrain
Abducent (6th) Most commonly involved in Ref: Essentials of Human Anatomy,
D
raised ICT 3/e, A.K Datta vol 2, p. 240
Occulomotor Commonly involved in
(3rd) & inracranial aneurysm TRIGEMINAL NERVE (V)
Abducent (6th)
6. Trochlear nerve all true except 1. Among the following cranial nerves the pure motor
A. Longest intracranial course nerves include all EXCEPT
B. Arises from dorsum of brainstem A. IV
C. Supply ipsilateral superior oblique muscle B. V
D. Enter orbit through sup.Orbital fissure C. VI
outside annula of Zinn. D. XI
Ans:-C Supply ipsilateral superior oblique Ref: Essentials of Human Anatomy,
B
muscle A.K Datta vol 2, 3/e, p. 172
Ref:-Gray’s 40/e p 275-288
Explanation:- 2. Anterior ethmoidal nerve supplies all except
Trochlear nerve is thinnest nerve. It is the only A. Maxillary sinus
nerve to emerge from dorsum of brain stem B. Infterior of nasal cavity
has longest intracranial course. It enters orbit C. Dural sheath of anterior cranial fossa
through outer part of superior orbital fissure D. Ethmoidal air cells
(ie lateral to annulus of zinn) and supplies A Ref: Gray’s Anatomy 38/e, p. 685
superior oblique muscle. Because it’s a cranial
nerve (with decussation in mid brain), the 3. Motor division of trigeminal nerve comes out
trochlear nerve nucleus supplies contralateral from
superior oblique muscle. A. Foramen spinousm
B. Foramen magnum
7. Cranial nerve not carrying parasympathetic fibers C. Foramen ovale
A. Fourth D. Foramen lacerum
B. Seventh C Ref: Gray’s Anatomy 39/e, p. 1237
C. Third
D. Ninth
4. Afferent sensation from the lower molar teeth is
Ans:-A i.e. Fourth
carried by
A. Facial nerve
B. Mandibular division of the trigeminal nerve
8. Cranial nerve not carrying parasympathetic fibres
C. Maxillary division of the trigeminal nerve
A. Fourth
D. Opthalmic branch of the trigeminal
B. Seventh
C. Third
B Ref: Gray’s Anatomy 39/e, p. 601
D. Ninth
A Ref: Gray’s Anatomy 38/e, p. 974
5. Masseteric nerve is a branch of
A. Long buccal nerve
9. Following is true about the Trochlear nerve EXCEPT B. Mandibular division of trigeminal nerve
A. Its nucleus is situated in the midbrain at the level of C. Maxillary division of the trigeminal nerve
inferior colliculus D. Motor branch of the facial nerve
B. It has general somatic efferent component
C. It is motor for superior oblique muscle of eyeball B Ref: Gray’s Anatomy 39/e, p. 523-24

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6. The innervation of tensor tympani muscle is C. Medial pterygoid


A. Vagus D. Anterior belly of digastric
B. Mandibular B Ref: Gray’s Anatomy 38/e, p. 1237, 796
C. Facial
D. Maxillary 12. Which of the following nerves are branches of
mandibular nerve
B Ref: Gray’s Anatomy 39/e, p. 658 A. Lingual, facial and palatine nerve
B. Lingual, inferior alveolar nerve
7. Which nerve is in close relation with the root of C. In ala and cervical nerves
lower 3rd molar D. All of the Above
A. Inferior alveolar nerve
B. Chorda tympani B Ref: Gray’s Anatomy 39/e, p. 1237
C. Lingual nerve
D. Mylohyoid nerve,
13. All are branches of posterior division of
C Ref: Gray’s Anatomy 38/e, p. 524 mandibular nerve except
A. Lingual nerve
8. Maxillary nerve innervates all of the following B. Inferior alveolar nerve
except C. Deep temporal nerve
A. Ala of nose and lower eyelid D. Mylohyoid nerve.
B. Upper cheeks
C. Gingivae of maxilla C Ref: Gray’s Anatomy 39/e, p. 573
D. TMJ 14. Sphenoidal air sinus is supplied by ____ nerve
A. Posterior ethmoidal nerve
D Ref: Gray’s Anatomy 38/e, p, 1234-36 B. Posterior superioro alveolar nerve
C. Sphenoidal nerve
9. All are true of mandibular nerve except D. Infratemporal nerve
A. Sensory branch arised from anterior trunk.
B. Muscles of mastication are innervated by A Ref: Gray’s Anatomy 39/e, p. 576
branches of main trunk.
C. Nerve to medial pterygoid arise rom main 15. Which of the following is not a branch of
trunk ophthalmic nerve
D. Buccal nerve innvervates buccinator muscle A. Frontal
D Ref: Gray’s Anatomy 38/e, p. 1237 B. Lacrimal
C. Nasociliary
10. Injury to motor division of the mandibular nerve D. Medial ethmoid
will cause paralysis of the following except
A. Medial pterygoid D Ref: Gray’s Anatomy 38/e, p. 1233
B. Muscles of mastication 16. Skin over the prominence of the cheek is supplied
C. Buccinator by
D. Anterior belly of digastric A. Zygomaticofacial
B. Zygomaticotemporal
C Ref: Gray’s Anatomy 38/e, p. 1237, 806 C. Auriculotemporoal
D. Infra trochlear
11. All the following muscles are supplied by
mandibular nerve except A Ref: Gray’s Anatomy 39/e, p. 512-13 fig 29.9
A. Masseter
B. Buccinator

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17. Which of the following is not true regarding Ref: Snell’s Clinical Neuroanatomy,
B
trigeminal nerve 5/e, p. 341
A. Roots of trirgeminal nerve are atattached to
pons
B. It has 3 main divisons 23. Which of the following is not a branch of Trigeminal
C. Supplies duramaeter of middle cranial fossa nerve
D. Trigeminal ganglion contributes to the sensory A. Maxillary
root only. B. Mandibular
C. Ophthalmic
C Ref: Gray’s Anatomy 39/e, p. 1230-31 D. Carotid

D Ref: Gray’s Anatomy 39/e, p .512-13


18. Which of following muscles is supplied by
mandibular nerve
A. Stapedius
24. Injury to motor divison of the mandibular nerve
B. Buccinator
will cause paralysis of the following EXCEPT
C. Tensor veli palatini
E. Medial pterygoid
D. Posterior belly of digastricd
F. Muscles of mastication
G. Buccinator
C Ref: Gray’s Anatomy 38/e, p. 1237
H. Anterior belly of digastric

19. Inferior alveolar nerve runs C Ref: Gray’s Anatomy 38/e, p. 1237, 806
A. Medial to lateral pterygoid
B. From infra temporal form 25. Maxillary nerve innervates all of the following
C. Lateral to medial pterygoid EXCEPT
D. Lateral to lateral pterygoid E. Ala of nose by lower eyelid
F. Upper cheeks
20. Mylohyoid nerve is a branch of G. Gingivae of maxilla
A. Main trunk of mandibular nerve H. TMJ
B. Ophthalmic nerve
D Ref: Gray’s Anatomy 38/e, p, 1234-36
C. Maxillary nerve
D. Inferior alveolar nerve
26. All are true of mandibular nerve EXCEPT
D Ref: Gray’s Anatomy 39/e, p.601
E. Sensory branch arises from anterior trunk
F. Muscles of mastication are innervated by
21. Following nuclei are associated with trigeminal nerve branches of main trunk
A. Mesencephalic, motor, sensor G. Nerve to medial pterygoid arise from main
B. Mesencephalic, principal sensory, motor and spinal trunk
C. Sensory, motor and spinal H. Buccal nerve innverates buccinator muscle
D. Principal sensory, mesencephalic and spinal.
D Ref: Gray’s Anatomy 38/e, p. 1237
Ref: Snell’s Clinical Neuroanatomy,
B
5/e, p. 341
27. Tumour infiltrating into the foramen ovale will
cause all EXCEPT
22. The fibers from trigeminal principal sensory nucleus
A. Anaesthesia of TMJ
reach the thalamus and form the
B. Paralysis of tensor tympani
A. Medial lemniscus
C. Paresthesia of hlips.
B. Trigeminal lemniscus
D. Paralysis of stylohyoid
C. Neo-trigemino thalamic tract
D. Trigemino-reticulo-thalamic pathway D Ref: Gray’s Anatomy 38/e, p. 1237

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D. Medial ethmoidal
28. All of the following structures are associcated D Ref: Gray’s Anatomy 39/e, p . 698-99
with branches of the trigeminal nerve EXCEPT the
A. Foramen ovale
33. Which of the following is a branch of ophthalmic
B. Superior orbital fissure
nerve?
C. Foramen rotundum
A. Nervus tentori
D. Stylomastoid foramen
B. Middle meningeal nerve
D Ref: Gray’s Anatomy 39/e, p, 1230 C. Nerve spinosus
D. Zygomatico facial

BA Ref: Gray’s Anatomy 39/e, p . 698-99

29. Mandibular nerve supplies


A. Anterior belly of digastic, mylohyoid, tensor
34. Taste sensation from tongue is not carried by
tympani, tensor palatini
A. VII nerve
B. Posterior belly of digastric, mylohyoid.
B. IX nerve
C. Stapes, melleus and incus.
C. X nerve
D. Anterior belly of digastric
D. V nerve
A Ref: Gray’s Anatomy 38/e, p. 1234 Ans:- D

35. False statement about trigeminal nerve


30. The fifth nerve innervates the following A. Carries sensation from face and scalp
A. Mylohyoid, anterior and posterior belly of B. Has motor branch
diagastric C. Arise from C8 nerve root
B. Mylohyoid, anterior belly of digastric, tensor D. Composed of spinal nucleus
tympani. Ans:- C i.e. Arise from C8 nerve root
C. Mylohyoid, posterior belly of digastric and
tensor lympani 36. A patient has loss of sensation at angle of mandible
D. Mylohyoid, posterior belly of digastric of (jaw) and parotid area. Which of the following nerve is
tensor tympani most likely to be injured
A. Mandibular nerve
B Ref: Gray’s Anatomy 38/e, p. 1230 B. Auriculotemporal nerve
C. Lesser occipital nerve
D. Greater auricular nerve
31. The proprioceptive fibres of mandibular nerve travel E. Supraclavicular nerve
through Ans:- D Greater auricular nerve
A. Sensory root Ref:- Snell’s clinical Anatomy 8/e p 727-729
B. Motor rod Explanation:-
C. Special root mesencephalic root - Angle of mandible is supplied by great
D. B and C auricular nerve Tip of nose is supplied by
Ref: Snell’s Clinical Neuroanatomy, ophthalmic division of trigeminal and side
A
5/e, p. 341 and alae of nose is supplied by maxillary
division of trigeminal nerve
32. Which of the following is not a branch of ophthalmic - The skin of face is supplied by three
nerve? divisions of trigeminal nerve, except for
A. Frontal the small area over the angle of mandible
B. Lacrimal and parotid gland which is supplied by
C. Nasociliary great auricular nerve

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- Spatial representation of face in spinal D. Facial nerve


nucleus of trigeminal nerve is more akin to Ans:- B i.e. Maxillary nerve
an onion skin pattern with fibers from Ref:- Keith Moore 6/e p. 1065, 850; Snell 8/c p 761-
central area of face reaching the highest 62; BDC 5/e p vol-3 p-233-35; Gray's student 2/e p-
part of nucleus and fibers from more 944
posterior part passing to progresively Explanation:-
lower levels of nucleus. Superior alveolar nerves (Anterior, Middle and
Posterior) are branches of maxillary nerve.
37. Of tip of nose is Infraorbital nerve is anterior continuation of
A. Maxillary nerve maxillary nerve that gives origin to middle and
B. Ophthalmic nerve anterior superior alveolar in infraorbital groove and
C. Facial nerve canal respectively. (Gray's student 2/e p 944)
D. Mandibular branch of Vth nerve
Ans:-B i.e. Opthalmic nerve 42. True about V3 nerve is all except
A. Lingual nerve runs with chorda tympani
38. Following are the branches of posterior division of B. Auriculotemporal embrace middle meningeal
mandibular nerve except artery
A. Buccal C. Otic ganglion is medial to nerve
B. Lingual D. Pure motor
C. Auriculotemporal E. Formed in foramen ovale
D. Inferior alveolar Ans:-D i.e. Pure motor

A Ref: Gray’s Anatomy 39/e, p. 523-24 43. Which of the following regarding mandibular nerve is
correct
39. Unilateral trigeminal N.injury is tested by A. Branch of facial nerve
A. Elevation and lowering of jaw B. Purely motor
B. Inability to tense the jaw C. Passes through foramen ovale
C. Blinking of eye D. Related to sphenopalatine ganglion
D. Corneal reflex Ans:- C i.e. Passes through foramen ovale
Ans:- A. i.e. Elevation & Lowering of jaw; D. i.e.
Corneal Reflex 44. Which of the following is not supplied by the anterior
division of mandibular nerve (V3)
40. Afferent component of corneal reflex is mediated by A. Temporalis
A. Vagus nerve B. Medial pterygoid
B. Facial nerve C. Lateral pterygoid
C. Trigeminal nerve D. Masseter
D. Glossopharyngeal nerve Ans:-B i.e. Medial pterygoid
Ans:- C i.e. Trigeminal nerve Explanation:-
Explanation:- Temporalis,messeter and lateral pterygoid muscles
The afferent component of corneal reflex is are supplied by anterior division of mandibular
mediated through the ophthalmic. Branch of the nerve whereas medial pterygoid muscle is supplied
trigeminal nerve. (V1 nerve) Infraorbital component by the main trunk of mandibular nerve
is mediate through the facial nerve (Vllth nerve).
45. Which nerve is in close relation with root of the lower
41. Middle superior alveolar nerve is a branch of third molar
A. Mandibular nerve A. Inferior alveolar nerve
B. Maxillary nerve B. Chorda tympanic nerve
C. Lingual nerve C. Lingual nerve
D. Myolohyoid nerve
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Ans:-C i.e. Lingual nerve Ref: Snell’s Clinical Neuroanatomy,


B
Explanation:- 5/e, p.341
Lingual nerve (br. of mandibular nerve) comes in
contact with the mandible, where the thin lingual
plate forms a shallow groove below and medial to 50. Sensory nerve supply of pinna is
the last (3rd) molar tooth, just above the posterior A. Mandibular nerve
end of the mylohyoid line. B. Maxillary nerve
C. Facial nerve
46. Nerve supply of the tympanic membrane is by the D. Abducent nerve
A. Auriculotemporal Ans:-A Mandibular nerve
B. Lesser occipital Explanation:-
C. Greater occipital Auriculotemporal nerve, a branch of mandibular
D. Parasympathetic ganglion nerve supplies the external acoustic meatus,
Ans:-A i.e Auricuotemporal external surface of auricle above this, skin of
Ref:- BDC 4th/e Vol III p255 Snell's Clinical temporal region and TM joint.
Anatomy 7th/e P-834 51. Mandibular nerve does not supply
Explanation:- A. Buccinators
Outer Surface B. Masseter
- Antero-inferior part by auricotemporal C. Tensor tympani
nerve (branch of mandibular V2, nerve) D. Temporalis
- Postero-superior part by auricular branch E. Diagastric (ant.belly)
of Vagus. Ans:- A Buccinators
Inner surface Ref:- Inderbir Singh Human Embryology 7/e p 115
Tympanic branch of glossopharyngeal nerve Explanation:-
through tympanic plexus. - Buccinators is supplied by facial 7th nerve
- Mandibular nerve (branch of trigeminal/5th
47. Root of auriculotemporal nerve embraces nerve) is nerve of 1st branchial arch and
A. The middle meningeal artery supplies all muscles derived from it, i.e.
B. The middle meningeal nerve
C. The otic ganglion 52. Upper premolars are supplied by
D. None of the above A. Anterior superior alveolar
A Ref: Gray’s Anatomy 39/e, p .524 B. Middle superior alveolar
C. Posterior superior alveolar
D. Inferior alveolar
48. The autonomic ganglion associated with lingual nerve
Ans:-B i.e. Middle superior alveolar
is
A. Otic ganglion
53. Which is the nucleus of Masseteric Reflex?-AI 08
B. Submandibular ganglion
A. Superior sensory nucleus of trigeminal nerve
C. Ciliary ganglion
B. Spinal nucleus of trigeminal nerve
D. None of the above
C. Mesenchephalic nucleus of trigeminal nerve
B Ref: Gray’s Anatomy 39/e, p .603 D. Dorsal nucleus of vagus nerve
Ans:- i.e., Mesencephalic nucleus of trigeminal
49. The proprioceptive impulses from muscles of facial nerve
expression travel through branches of Ref:- Gray’s:, Anato y 39/e p. 341; BDC 4/e vol-III
A. Facial nerve p- 335; Lange: clinical neuroanatomy 25/e p- 113;
B. Trigeminal nerve High yield neuroanatomy 3/e p-91
C. Glossopharyngeal nerve Explanation:-Jaw jerk (masseteric) reflex involves
D. None of the above mesencephalic (afferent) and motor (efferent)
nucleus of trigeminal nerve.
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58. Branch of the mandibular nerve which commonly


54. Trigeminal nerve has how many nuclei in CNS splits around the middle meningeal artery and send
A. Three twigs to TMJ is
B. Four A. Facial
C. Five B. Buccal
D. Six C. Occipital
Ans:-B Four D. Auriculotemporal
Ref:- Snell Neuroanatomy 7/e p 341-43 D Ref: Gray’s Anatomy 39/e, p. 524
Explanation:-
Trigeminal nerve has 4 nuclei which are main
59. Maxillary division of trigeminal nerve passes through
sensory nucleus (carrying sensation from face
A. Superior orbital fissure
and anterior scalp), motor nucleus (supplying
B. Foramen rotundum
muscles of mastication, tensor
C. Foramen ovale
tympani/palatine, mylohyoid and digastric
D. Foramen spinosum
anterior belly), mesencephalic nucleus and
Ref: Essentials of Human Anatomy,
spinal nucleus (extending in medulla oblongata B
3/e, A.K Datta vol 2, p. 219
and spinal cord upto C2 segment)

55. If an injury occurs to the motor root of the trigeminal ABDUCENT NERVE (VI)

nerve all the following muscle would be affected 1. Medial squint is caused by paralysis of?

EXCEPT A. Trochlear

A. Anterior belly of digastrics B. Occulomotor

B. Mylohyoid C. Abducent

C. Buccinators D. Optic

D. Tensor tympani Ans:- C

Ref: Snell’s Clinical Neuroanatomy,


C 2. Which is a direct content of cavernous sinus-DNB 03,
5/e, p. 341
Kerala 97
A. Ophthalmic division of trigeminal nerve
56. Branches of the ophthalmic division of the fifth
B. Trochlear nerve
cranial nerve leave the middle cranial fossa through
C. Abducent nerve
the
D. Occulomotor nerve
A. Inferior orbital fissure
Ans:- C i.e. Abducent nerve
B. Superior orbital fissure
C. Lacrimal foramen
3. Dorello’s canal transmits in tip of temporal bone-PGI
D. Orbital foramen
1999
Ref: Gray’s Anatomy 39/e, p. 690-97-1
B A. Middle meningeal artery
fig 41.17
B. Mandibular nerve
C. Superior alveolar branch of maxillary
57. Infraorbital nerve is a branch of
D. Abducent nerve
A. Facial
Ans:- D. i.e. Abducent nerve
B. Maxillary
Ref:- Human anatomy by A. Halim 1/e P-51
C. Mandibular
Explanation:-
D. None of the above
Dorello canal is an opening to cavernous sinus that
B Ref: Gray’s Anatomy 39/e, p. 578 transmit abducent nerve underneath the superior
petrosal sinus.

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4. Injury of VI cranial nerve results in B. Joins lingual nerve in infratemporal fossa


A. Medial convergent squint C. Is a branch of facial nerve
B. Lateral divergent squint D. Contains postganglionic parasympathetic
C. Paralysis of medial rectus muscle fibres.
D. Paralysis of superior oblique muscle.
Ref: Snell’s Clinical Neuroanatomy, D Ref: Gray’s Anatomy 39/e, p. 627-28
A
5/e, p. 369

4. Which of the following is a branch of facial nerve


5. A patient having paralysis of Abducens nerve would A. Deep petrosal nerve
have B. Lesser superficial petrosal nerve
A. Medial or convergent squint C. External petrosal nerve
B. Lateral or divergent squint D. Greater superficial petrosal nerve
C. Diplopia on adduction D Ref: Gray’s Anatomy 39/e, p. 660
D. None of the above
Ref: Snell’s Clinical Neuroanatomy,
A 5. Unilateral supranuclear lesion of facial nerve
5/e, p. 359
involves
A. Whole of face
6. A patient having diplopia while climbing down the
B. Only ipsilateral upper part of the face
stairs or while reading could be suspected to have
C. Only contra lateral lower part of the face
A. Paralysis of III nerve
D. Whole of lower face
B. Paralysis of IV nerve
C Ref: Gray’s Anatomy 39/e, p. 661
C. Paralysis of VI nerve
D. A and B

B Ref: Gray’s Anatomy 39/e, p . 694


6. All of the following is true of facial nerve except
A. Supplies motors branches to the muscles of
FACIAL NERVE (VII) facial expression
B. It has no sensory component
C. The muscles of the eyelid will be spared in
1. Somatic efferent does not include upper motor neuron lesions
A. Facial nerve D. It is a nerve of 2nd arch
B. Occulomotor nerve
C. Abducens
B Ref: Gray’s Anatomy 39/e, p. 337
D. Trochlear
A Ref: Gray’s Anatomy 39/e, p. 229

7. The special visceral afferent fibres of the facial


2. Injury to which nerve will affect lacrimal
nerve are located in which nuclei
secretions
A. Motor nucleus
A. Greater petrosal nerve
B. Nucleus ambiguous
B. Lesser petrosal nerve
C. Nucleus of tractus solitarius
C. Sphenopalatine nerve
D. Lacrimatory nucleus
D. Nasocilliary nerve
A Ref: Gray’s Anatomy 39/e, p. 685
C Ref: Gray’s Anatomy 38/e, p. 1244

3. The following statement concerning chorda


tympani nerve are true except that it
8. All the following nerves are related to mandible
A. Carries secretomotor fibres to submandibular
except
gland.
A. Lingual nerve

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B. Auriculotemporal nerve Ref: Essentials of Human Anatomy,


B
C. Chorda tympani 3/e, A.K Datta vol 4, p.253
D. Mental nerve.

C Ref: Gray’s Anatomy 38/e, p. 576-77


14. The facial nerve
A. Arises from the medulla oblongata
9. Branches of facial nerve are B. Transverses through parotid gland
A. Digastric C. Supplies muscles of mastication
B. Stylohyoid D. Carries no taste fibres
C. Posterior auricular
D. All of the above B Ref: Gray’s Anatomy 39/e, p. 1243-47
D Ref: Gray’s Anatomy 38/e, p. 1246

10. The right facial nerve damage 15. Following nuclei are associated with the facial nerve
A. There is paralysis of facial muscles A. Superior salivatory, inferior, salivatory, lacrimatory,
B. There is paralysisof of muscles of mastication motor.
C. Paralysis of vocal cords B. Superior salivatory, tractus solitarius, lacrimatory,
D. A and B motor
A Ref: Gray’s Anatomy 39/e, p. 506 C. Superior salivatory, inferior salivatory, lacrimatory,
tractus solitaries
D. Inferior salivatory and motor
11. Smiling and frowning are actions produced by the
Ref: Snell’s Clinical Neuroanatomy,
following nerves B
5/e, p. 345
A. Mastication trigeminal (V cranial)
B. Mastication facial (VII cranial)
C. Facial expression trigeminal (V cranial) 16. Facial nerve has
A. Motor root only
D. Facial expression facial (VII cranial)
B. Motor and sensory root
C. Motor and sympathetic root
D Ref: Gray’s Anatomy 39/e, p. 1246
D. Motor, sympathetic and parasympathetic

B Ref: Gray’s Anatomy 39/e, p. 660

12. Which of the following nerves carries gustatory and


parasympathetic fibers? 17. Lacrimation does not occur when facial nerve
A. Deep petrosal nerve injury is at
B. Greater petrosal nerve A. Geniculate ganglion
C. Lesser petrosal nerve B. In semicircular canal
D. External petrosal nerve C. At sphenopalatine ganglia
D. At mastoid foramen
B Gray’s Anatomy 39/e, p. 680
A Ref: Gray’s Anatomy 39/e, p. 660-61

13. Following are the functional components of facial


nerve EXCEPT 18. The branch of facial nerve that conveys
A. Special visceral afferent the secretomotor impulse involved in
B. Special somatic afferent lacrimation is
C. General visceral afferent A. Chorda tympani nerve
D. Special visceral afferent B. Deep petrosal nerve

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C. Greater petrosal nerve A. Secretomotor to submandibular gland


D. Lesser petrosal nerve B. Large motor and small sensory root
Ans: C C. Supplies anterior belly of digastric
Ref: BD Chaurasia,1/E, p. 180 D. Parasympathetic innervation to palatal and nasal
glands
19. Unilateral supranuclear lesion of facial Ans:- C
nerve involves
A. Whole of face 25. If the seventh nerve is damaged on the
B. Only ipsilateral upper part of the right side of the face:
face A. The muscles of mastication would be
C. Only contra lateral lower part of the denervated
face B. The muscles of facial expression
D. Whole of lower face would be denervated
Ans: C C. Taste from the right anterior two
Ref: BD Chaurasia, 1/E, p. 173 thirds of the tongue would not be
affected
20. Which one of the following is seen in facial palsy D. Sympathetic fibre to salivary gland
A. Drooping of eyelid would be interrupted
B. Loss of taste sensation in anterior 2/3 of tongue Ans:B. The muscles of facial expression would be denervated
C. Excess of saliva secretion Ref: B D Chaurasia, 5/E, p. 354
D. Loss of general sensation in check Explanation
Ans:-B • If damage occurs to 7th nerve occurs facial muscle
expression, parasympathetic action of salivary glands and
21. Which of following is not true about facial nerve? taste sensation from anterior 2/3rd of tongue will be affected
A. It has small sensory and large motor root
B. It supply anterior belly of digastrics 26. All of the following cranial nerves contain somatic
C. It gives parasympathetic supply to nasal and efferents, except-AI 08
lacrimal glands A. VII Nerve (Facial nerve)
D. It is secretomotor to submandibular salivary B. III Nerve (Occulomotor nerve)
glands C. IV Nerve (Trochlear nerve)
Ans:- B D. VI Nerve (Abducent nerve)
Ans:- A i.e. Facial
22. Which nerve can be damaged by excessive pressure on
angle of mandible during maintaining patent airway? 27. Which nerves does not arise from the medulla-AIIMS
A. V 92, WB 05, DNB 04
B. VI A. Facial
C. VII B. Glossopharyngeal
D. VIII C. Vagus
Ans:- C D. Dorsal horn of gray matter
Ans:- A i.e. Facial
23. In facial nerve injury just above the branching of Explanation:-
chorda tympani nerve, which is not seen The 3rd & 4th cranial nerves belong to midbrain;
A. Paralysis of facial muscles 5th, 6th, 7th, & part of 8th, to mid brain and
B. Decreased salivation remaining (8th, 9th, 10th, 11th, 12th,) to medulla
C. Loss of taste sensation oblongata.
D. Hyperacusis
Ans:- D 28. Which of the following are branch of facial nerve
A. Chorda tympani
24. Which of the following is not true about facial nerve B. Lesser petrosal nerve
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C. Greater petrosal nerve C. External petrosal nerve


D. Zygomatic nerve D. Greater superficial petrosal nerve
E. Nerve to stapedius Ans:-D i.e. Greater superficial petrosal nerve
Ans:- A i.e. Chorda tympani; C i.e. Greater
petrosal nerve; D i.e. Zygomatic nerve; E i.e. Nerve 35. First branch of facial nerve is
to stapedius. A. Chorda tympani
B. Nerve to stapedius
29. Branch of facial nerve in facial canal C. Lesser superficial petrosal N
A. Greater petrosal nerve D. Greater superficial petrosal N
B. Lesser petrosal Ans:- D. i.e. Greater Superficial petrosal nerve
C. Chordatympani
D. Nerve to stapedius 36. A person met with knife injury to face and resultant
Ans:- A. i.e. Greater petrosal nerve; C. i.e. Chorda damage to facial nerve. It leads to impaired decreased
tympani; D. i.e. N. to stapedius secretion from
A. Parotid gland
30. All the muscles of the face are supplied by facial nerve B. Sublingual gland
except C. Lacrimal gland
A. Levator anguli oris D. Parotid gland,sublingual gland and
B. Corrugators supercilli submandibular gland
C. Leavator palpebrae superioris E. None
D. Risorius Ans:- E i.e. None
Ans:- C i.e. Levator palpebrae superioris
37. Facial nerve supplies
31. Posterior belly of digastrics is supplied by A. Risorius
A. Mandibular nerve B. Anterior belly of digastrics
B. Hypoglossal nerve C. Lateral pterygoid
C. Accessory nerve D. Zygomaticus
D. Facial nerve E. Auricular muscles
Ans:- D i.e. Facial nerve Ans:- A i.e. Risorius; D i.e. Zygomaticus; E i.e.
32. Stapedius muscle is supplied by …. Nerve Auricular muscles
A. Facial
B. Vagus 38. Muscles supplied by facial nerve are
C. Glossopharyngeal A. Stapedius
D. Trochlear B. Anterior digastrics
Ans:- A i.e. Facial nerve C. Risorius
D. Stylohyoid
33. Drooping of upper eyelid results when there is E. Platysma
paralysis of Ans:- A i.e. Stapedius; C i.e. Risorius; D i.e
A. Temporal branch of facial nerve Stylohoid; E i.e Platysma.
B. Zygomatic branch of facial nerve
C. Occulomotor nerve 39. Which muscles are supplied by facial nerve
D. Nasociliary nerve A. Platysm

A Ref: Gray’s Anatomy 39/e, p .691 B. Superior belly of omohyoid


C. Stylohyoid
D. Buccinators
34. Which one of the following is a branch of the facial
E. Masseter
nerve
Ans:- A i.e., Platysma C i.e. Stylohyoid D i.e.
A. Deep petrosal nerve
Buccinator
B. Lesser superficial petrosal nerve

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40. Facial N. stimulation during testing of nerve indicated nerve - Geniculate ganglion - Nucleus of
by contraction of muscle solitary tract
A. Temporalis - Sensory innervation of face &
B. Masseter anterosuperior part of scalp is provided
C. Sternoleidomastoid mainly by trigeminal nerve, whereas
D. Orbiculatri oris motor innervation of facial muscles
Ans:- D i.e. Orbicularis oris (including muscles of scalp, eyelids, nose,
lip except levator palpebrae superioris
41. All the following muscles are innervated by the facial which is supplied by 3rd nerve) is
nerve except provided by nerve of IInd pharyngeal arch
A. Occipito- frontalis i.e. facial nerve (CN VII). Muscles of
B. Anterior belly of digastrics masseter, temporalis, lateral & medial
C. Risorius pterygoid) are supplied by mandibular
D. Procerus division of trigeminal nerve.
Ans:- B. i.e. Anterior belly of digastrics - Facial nerve supplies muscle of Ilnd
42. Nerve supply of stapedius is pharyngeal arch; Mn- "Stupid Style Has
A. 2nd nerve Dipped - Scalp, Ear, Eye lid, Nose, Lip and
B. 3 nerve
rd Neck Expression"
C. 5th nerve
D. 7th nerve 43. Sensory fibres from the taste buds in the bard and soft
Ans:- . D. i.e. 7th nerve palate travel along
Ref:- Gray's 40/e p 495-94, 629-30, 295, 234, 543; A. Trigeminal nerve
BDC 5/e vol-111 p 354-58; Keith Moore 6/e p 853- B. Facial nerve
54,1056-57, 1068-70; Snell 9/e p 612/e p 493-98; BRS- C. Glossopharyngeal nerve
Neuroanatomy 4/e p 183-85; Fuller's neurological D. Vagus nerve
examination made easy 2/e p-85 Ans:- B i.e. Facial nerve
Explanation:-
- Before exiting cranium, through 44. Absence of lacrimation is seen in which nerve injury
stylomastoid foramen, all parasympathetic A. Nasociliary nerve
secretomotor fibers leave facial nerve.So B. Greater petrosal nerve
facial lesion in face would result only in C. Supraorbital nerve
motor involvement of terminal branches. – D. Infraorbital/ Ethmoidal nerve
- Greater superficial petrosal nerve is 1st Ans:- B i.e. Greater petrosal
branch of facial nerve, it arises from
geniculate ganglion. Nerve to stapedius 45. Sphenopalatine ganglion is associated with
and chorda tympani braces also arise in A. Great superficial petrosal nerve
facial canal. B. Glossopharyngeal nerve
- Anterior belly of digastric is supplied by C. Deep petrosal nerve
mylohyoid nerve (br. of trigeminal n.) and D. Vagus nerve
posterior belly of digastric is supplied by A Ref: Gray’s Anatomy 39/e, p . 574
facial nerve.
- Stapedius muscle is supplied by 7th cranial
46. The parasympathetic secretomotor fibres for
nerve & tensor tympani muscle is supplied
submandibular and sublingual gland originate in
by mandibular (5th C.N.)Nerve both are
nuclei of
muscles of middle ear.
A. Facial nerve
- Gustatory nerve supply of soft palate
B. Trigeminal nerve
travels along facial nerve. The pathway is
C. Glossopharyngeal nerve
Lesser palatine nerve Greater petrosal
D. Hypoglossal nerve

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- Greater (superficial) petrosal nerve arise


A Ref: Gray’s Anatomy 39/e, p .603
from geniculate ganglion of facial nerve
(as its first branch) & enters middle cranial
47. In the fracture of middle cranial fossa, absence of tears fossa. In foramen lacerum it unites with
would be due to lesion in deep petrosal nerve to form nerve of
A. Trigeminal ganglion pterygoid canal. Ultimately fibres supply
B. Ciliary ganglion lacrimal gland & mucosal glands of nose,
C. Greater petrosal nerve palate & pharynx after passing through
D. Cervical ganglion pterygo or spheno-palatine ganglion
Ans:- C i.e. Greater petrosal nerve - Pterygo (or spheno) palatine ganglion is
the largest parasympathetic peripheral
48. Lacrimal gland is supplied by which of the following ganglion. Topographically, it is related to
ganglia the maxillary nerve, but functionally it is
A. Otic ganglia connected to facial nerve through greater
B. Ciliary ganglion petrosal branch. It serves as a relay station
C. Spehnoplatine ganglion for secretomotor fibres to the lacrimal
D. Submandibular gland, mucous glands of nose, paranasal
Ans:- C i.e. Sphenopalatine ganglion sinuses, palate & pharynx. (Hay fever
ganglion)
49. Sphenopalatine ganglion does not supply - Innervation of lacrimal gland or
A. Nasal mucosa secretomotor pathway of lacrimation (Mn
B. Sublingual gland G2 P2 Z2 L2)- any damage in this:,
C. Ciliary ganglion diminish lacrimation.
D. Palate
Ans:- B i.e. Sublingual gland; C i.e. Ciliary 51. Lacrimal secretion are decreased when facial nerve
ganglion injury occurs at the following site
A. Middle ear
50. Lacrimal secretion is diminished when which site of B. Mastoid foramen
nerve is damaged C. Geniculate ganglion
A. Parotid nerve D. Sphenopalatine ganglion
B. Gasserian ganglia Ans:- C i.e. Geniculate ganglion
C. Ciliary ganglia
D. Pterygopalatine ganglion 52. The nerve supplying submandibular gland is
Ans:- D i.e. Pterygopalatine ganglion A. V
Ref:- BDC 4/e Vol.111 237, 103, 138-41; Snell's B. IX
Clinical Anatomy 7/e p.843; Keith Moore Clinical C. VII
Oriented Anatomy 5/e p.1138 D. XII
Explanation:- Ans:-C i.e. VII
- Lacrimal secretion is diminished with
damage to pterygo-palatine or spheno- 53. The secretomotor fibre to the parotid gland passes
palatine or hay fever ganglion and through
geniculate ganglion A. Otic ganglion
- Geniculate ganglion is morphologically & B. Sphenopalatine ganglion
functionally related to facial nerve; where C. Geniculate ganglion
as pterygo (spheno) palatine ganglion is D. Lesser ganglion
part of maxillary nerve and only Ans:- A i.e. Otic ganglion
functionally related to facial nerve through
greater petrosal nerve; that's why the 54. All of the following are supplied by the facial nerve
better geniculate ganglion. except
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A. Lacrimal gland 57. Blood supply of facial nerve are


B. Submandibular gland A. Ascending pharyngeal artery
C. Nasal gland B. Middle meningeal artery
D. Parotid gland C. Greater palatne
Ans:- D i.e. Parotid gland Ans:- A , B, D i.e. Ascending pharyngeal artery,
Ref:-Keith Moore 4/e p 870, 948, 1100; Snell's 7/e p. Middle meningeal artery, Stylomastoid branch of
904; Fuller's neurological examination made easy occipital artery
2/e p-85; BDC 4/c Vol.111 138-41,103
Explanation:- 58. Blood supply of facial nerve
supplies lacrimal gland, mucosal glands of nose, A. Stylomastoid branch of facial nerve
palate & pharynx, submandibular & sublingual B. Facial artery
Facial nerve supplies lacrimal glands of nose, palate C. Lingual artery
and pharynx, submadibular and sublingual glands D. Ascending pharyngeal artery
not parotid gland in which it is divided into E. Stylomastoid
terminal branches. Ans:- D i.e. Ascending pharyngeal artery; E i.e.
Stylomastoid
55. The following statements concerning chroda tympani
nerve are true except that it 59. In lower motor neuron lesions of the facial nerve
A. Carries secretomotor fibers to submandibular A. Ipsilateral lower half is paralysed
gland B. Ipsilateral whole face is paralysed
B. Joins lingual nerve in infratemporal fossa C. Contra lateral whole face is paralysed
C. Is a branch of facial nerve D. Contra lateral lower hair is paralysed
D. Contains postganglionic parasympathetic
fibers Ref: Snell’s Clinical Neuroanatomy,
1. B
Ans:- D i.e. Contains postganglionic 5/e, p. 361
parasympathetic fibres
60. The following statement concerning chorda tympani
56. In relation to chorda tympani nerve which of the nerve are true EXCEPT that it
following statement is true A. Carries secretomotor fibers to submandibular gland
A. Branch given by facial nerve in temporal bone B. Joins lingual nerve in infratemporal fossa
B. It carries postganglionic secretomotor fibres C. Is a branch of facial nerve
C. It joins lingual nerve D. Contains post ganglionic parasympathetic fibres
D. It carries taste sensation
2. D Ref: Gray’s Anatomy 39/e, p . 525
E. It carries secretomotor fibres to sublingual and
submandibular gland
Ans:- A i.e. Branch given by facial nerve in 61. Hyperacusis can result, after paralysis of;

temporal bone; C i.e. It joins lingual nerve; D i.e. A. Facial nerve

It carries taste sensation; E i.e. It carries B. Posterior auricular

secremotor fibers to sublingual & submandibular C. VIII nerve

gland D. None of the above

Ref:- Snell 7/e P-779: 841: Keith Moore 4/e P-870, Ref: Snell’s Clinical Neuroanatomy,
A
948,1100 5/e, p. 360
Explanation:-
Chorda tympai nerve contains preganglionic 62. In facial palsy the muscle which is paralysed is
secretomotor parasympathetic fibres that synapse A. Levator palpebrae superioris
on cell bodies in the submandibular ganglion. It B. Orbicularis oculi
does not contain post ganglionic parasympathetic C. Constrictor pupil
fibres. D. Dilator pupil

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Ref: Snell’s Clinical Neuroanatomy, Anatomy 39/e p. 674-78, 234, 339.436


B
5/e, p. 360 Explanation:-
- Vestibular nuclei is located in floor of 4th
63. In supranuclear lesions of facial nerve ventricle & is supplied by PICA
A. The whole of the face is paralysed on affected side - Vestibular ganglion is also k/a Scarpa's
B. Only lower part of face is paralysed ganglion. Vestibular nerve anastomose with
C. Whole of face is paralysed on contra lateral side cochlear nerve (anastomosis of Oort) and facial
D. Paralysis occurs on the both sides of the face nerve.
Ref: Snell’s Clinical Neuroanatomy,
B
5/e, p. 360-361 GLOSSOPHARYNGEAL NERVE (IX)
1. Taste sensations from circumvallate papilla are carried
64. A patient came to the hospital with one side of the through
whole face paralysed. The face had become A. Facial nerve
asymmetrical and drawn up to the normal side; the B. Glossopharyngeal nerve
affected side is motionless, articulation and speech are C. Trigeminal nerve
impaired. This would be case of D. Vagus nerve
A. Supranuclear lesion of facial nerve Ans: B
B. Infranuclear lesion of facial nerve
C. Lesion of trigeminal nerve 2. Sensory nerve supply of the middle ear cavity is
D. None of the above provided by
Ref: Essentials of Human Anatomy, A. Facial
B A.K Datta vol 2, Head and Neck, p. B. Glossopharyngeal
335-36 C. Trigeminal
D. Vagus
65. Nerve of the pterygoid canal is formed by union of Ans:-B i.e Glossopharyngeal
A. Deep petrosal nerve with greater Ref:- Gray’s 39/e p 651
petrosal nerve Explanation:-
B. Deep petrosal nerve with lesser Glossopharyngeal nerve- Tympanic
petrosal nerve nerve/Tympanic plexus - Middle ear, Auditory tube
C. Greater petrosal and lesser petrosal Mastoid antrum.
nerves
D. Greater petrosal and external
petrosal nerves 3. Glossopharyngeal nerve leaves the skull
Ans: A A. Through jugular foramen and lies anterior to X and
Ref: BD Chaurasia, 1/E, p. 213 XI
B. Through foramen lacerum anterior of X and XI
VESTIBULO COCHLEAR NERVE (VIII) nerves
1. True about vestibular nerve-PGI June 07 C. Through jugular foramen and lies in middle or X
A. Nucleus is supplied by PICA and XI nerves
B. Anastomotic connection with facial nerve D. Through foramen spinosum post of posterior to X
C. Vestibular ganglion also called scarpa’s and XI nerves
ganglion A Ref: Gray’s Anatomy 39/e, p . 556
D. Connection with trigeminal nerve
Ans:- A i.e. Nucleus is supplied by PICA; B i.e.
4. (a) IX N descends between the IJV and ICA and
Anastomotic connection with facial nerve; C i.e.
(b) lies deep to stylohyoid process
Vestibular ganglion also called scarp' ganglion
A. Both statements are true
Ref:- Snells Neuroanatomy 6/e p. 157, 355-56; IBS
B. A is true but IX nerve lies superficial to stylohyoid
Neuroanatomy 6/e p. 110, 115, 159; Gray's
process

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C. Is true but IX nerve descends between X nerves and C. Vagus


IJV D. Hypoglossal
D. Both statements are false Ans: C

A Ref: Gray’s Anatomy 39/e, p . 556 Ref: BD Chaurasia, 5/E, p. 363


Explanation
Vagus nerve (Xth CN) is so called
5. (a) IX nerves enters submandibular region
because of its extensive (Vague) course
(b) lies deep to Hyoglossus muscle
through the head, neck, thorax and
A. A is true but IX N lies superficial to hyoglossus
abdomen
B. Both statements are false
C. Both statements are true
4. All of the following statements about the vagus nerve
D. A is false and b is true
are true except that it
C Ref: Gray’s Anatomy 39/e, p . 556 A. Supplies heart and lung
B. Carries postganglionic parasympathetic fibers
6. Following are the functional components of C. Innervates right two third of transverse colon
glossopharyngeal nerve EXCEPT D. Stimulates peristalsis and relaxes sphincters
A. General somatic afferent Ans:- B i.e. Carries postganglionic
B. Special visceral afferent parasympathetic fibres
C. Special visceral efferent Ref:- Grays Students 1/e P-180, 188-90, 805-06, 800;
D. General visceral efferent BDC 4/e Vol. 111 P-183-85; Dutta Neuroanatotny
Ref: Essentials of Human Anatomy, 2/e P-248-51; 7/e P- 904-08,818; IBS Neuroanatomy
A 6/e P-114- 15, 240-46
3/e, A.K Datta vol 4, p. 257
Explanation:-
Parasympathetic general visceral efferent out flow

VAGUS NERVE (X) of vagus is through preganglionic fibers, as


postganglionic neurons related to vagus are located

1. External laryngeal nerve supplies following muscle in thoracic and abdominal autonomic plexus, close

A. Sternothyroid to or, within, the viscera supplied. It supplies

B. Cricothyroid - Gastrointestinal tract from pharynx to the

C. Lateral cricoarytenoid junction of the right 2/3rd and left 1/3rd of

D. Thyroarytenoid transverse colon. (The left 1/3rd of


transverse colon descending colon, the
B Ref: Gray’s Anatomy 39/e, p. 642, 643, 644
sigmoid colon, rectum and upper part of
anal canal are supplied by sacral part of
parasympathetic system). As a rule,
2. Which of the following is innervated by the vagus
parasympathetic nerve stimulate'intestinal
nerve
movements and inhibit the sphincters,
A. The levator veli palatini
they are secretomotor to mucosal glands.
B. Posterior belly of digastric
- Heart and lung the parasympathetic
C. Mylohyoid
preganglionic neurons are located in the
D. Tensor veli palatini
dorsal nucleus of vagus and stimulation
A Ref: Gray’s Anatomy 38/e, p. 1252
reduces heart rate and leads to broncho
constriction.

3. All the cranial nerves provide innervations 5. Recurrent laryngeal nerve had following course in
for the structures in the head and neck except one, that neck
additionally supplies the thorax and abdomen A. It passes anterior to inferior thyroid artery
A. Glossopharyngeal B. It passes through sternomastoid
B. Spinal accessory
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C. It passes through branches of inferior thyroid B. Thyroarytenoid


vessels C. Post cricoarytenoid
D. It passes posterior to inferior thyroid vessels D. Cricoarytenoid
E. It is superficial to inferior constrictor muscle Ans:- A. i.e. Cricothyroid
Ans:- A i.e. It passes anterior to inferior thyroid Explanation:-
artery; C. i.e. It passes between branches of All intrinsic muscles of larynx are supplied by
inferior thyroid vessels; D i.e. It passes posterior recurrent laryngeal n. except cricothyroid which is
to inferior thyroid vessels supplied by external branch of superior laryngeal
Ref:- BDC 4th/e Vol 111 P-185 nerve i.e. external laryngeal nerve.
Explanation:-
Right recurrent laryngeal n. may be superficial or 7. The recurrent laryngeal nerve supplies
deep to the inferior thyroid artery. Occasionally A. Vocalis muscle
some branches are superficial & some are deep. Left B. Posterior cricoarytenoid
recurrent layrngeal n. is usually deep to inferior C. Cricothyroid
thyroid artery. D. Stylopharyngeus
Important Branches of Vagus E. Omohyoid
Superior laryngeal nerve Ans:- A. i.e. Vocalis; B. i.e. Posterior
- Runs over superior constrictor & reach cricoarytenoid
middle constrictor where it divides. Ref:- BDC 4/e Vol 111 P-244-46; P. L Dhingra 3/e P-
External laryngeal n. Internal laryngeal n. 337-8; Last's Anatomy 11/e p.351, 411, 397, 401, 216,
Accompanies superior Pierce thyrohyoid 381
thyroid a membrane Explanation:-
Pierce inferior Supply mucous - All intrinsic muscles of larynx i.e. posterior
constrictor membrane of larynx cricoarytenoid (abductor); thyroarytenoid,
upto vocal folds inter aryten arytenoids/transverse
Supply cricothyroid arytenoid, lateral cricoarytenoid
muscle (adductors); Vocalis (tensor);
thyroepiglottic (openers)Q are supplied by
Recurrent laryngeal nerve recurrent laryngeal nerve except
- Rt. recurrent laryngeal n. arise in neck, cricothyroid which is supplied by external
may be superficial, deep or both to inferior laryngeal nerve
thyroid artery - Stylopharyngeus is supplied by
- Lt. recurrent laryngeal n. arise in thorax, glossopharyngeal nerve
loops around ligamentum arteriosum and - Omohyoid is supplied by ansa cervicalis
is usually deep to inferior thyroid a.
- Passes deep to inferior constrictor & enter 8. Cricothyroid is supplied by
larynx A. Recurrent laryngeal nerve
- It supply B. Internal laryngeal nerve
 All intrinsic muscles of larynx C. External laryngeal nerve
except cricothyroid D. Hypoglossal nerve
 Mucous membrane below vocal Ans :- C i.e. External laryngeal nerve
cord 9. Injury of which of these nerve cause vocal cord
 Br. to deep cardiac plexus, paralysis
trachea, oesophagus & inf. A. Recurrent laryngeal
Constrictor. B. External laryngeal
C. Internal laryngeal
6. Ext branch of sup. Laryngeal N. supply D. Superior laryngeal
A. Cricothyroid

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Ans:- A. i.e. Recurrent laryngeal nerve A. Carotid, superior laryngeal, internal laryngeal and
Ref:- BDC Vol III P-243-4 left recurrent laryngeal
Explanation:- B. Auricular, carotid, superior laryngeal, right
All muscles of vocal cord (larynx) except recurrent, cardia
cricothyroid are supplied by recurrent laryngeal C. Sup laryngeal, internal laryngeal, left recurrent
nerve. laryngeal, cardia
Nerve supply of Larynx (Vocal cord) D. Meningeal, auricular, left recurrent laryngeal
Motor Sensory B Ref: Gray’s Anatomy 39/e, p 557
Cricothyroid muscle by Mucous membrane
external laryngeal n. (br. of upto vocal folds by
14. Stimulations of which branch of vagus produces
superior laryngeal n.) internal laryngeal n.
increase in appetite
A. Meningeal
All others Mucous membrane
B. Auricular
(oblique/transverse/thyro- below vocal folds by
C. Pharyngeal
arytenoid; lateral/posterior- recurrent
D. Cardiac
cricoarytenoid & thyro-
Ref: Essentials of Human Anatomy,
epiglottic) by recurrent
B A.K Datta vol 2, 3/e, Head and Neck,
laryngeal .n
p. 183

15. In carotid sheath


A. Vagus nerve lies posteriorly and in the middle of
10. Nerve supply to vocal cords is by
ICA and IJV
A. Internal laryngeal nerve
B. Ansa cervicalis is embedded in the lateral wall
B. Recurrent laryngeal nerve
C. Cervical sympathetic chain in plastered to its
C. Superior laryngeal nerve
posterior wall
D. Internal and recurrent laryngeal nerve
D. Common carotid artery is not there
B Ref: Gray’s Anatomy 39/e, p. 698
A Ref: Gray’s Anatomy 39/e, p. 342

11. All the cranial nerves provide innervations for the


structure in the head and neck except one, that 16. Auricular branch of vagus is otherwise called as
additionally supplies the thorax and abdomen A. Jacobson’s nerve
A. Glossopharyngeal B. Herring’s nerve
B. Spinal accessory C. Alderman’s nerve
C. Vagus D. Vidian nerve
D. Hypoglossal Ref: Essentials of Human Anatomy,
C Ref: Gray’s Anatomy 39/e, p. 336-67 C A.K Datta vol 2, Head and Neck, p.
183

12. The nerve which transverse the head, neck throat and
abdomen; 17. Following are the functional components of vagus
A. IX nerve EXCEPT
B. X A. General visceral efferent
C. XI B. Special visceral efferent
D. Phrenic nerve C. General somatic efferent
D. Special visceral efferent
B Ref: Gray’s Anatomy 39/e, p .556-57
Ref: Essentials of Human Anatomy,
C
3/e, A.K Datta vol 4, p. 258-59
13. Following are the direct branches of the vagus nerve;

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7. Cranial accessory nerve supplies


SPINAL ACCESSORY NERVE (XI) A. Stenomastoid
1. All of the following carry proprioception from B. Trapeizius
head and neck except C. Splenius capitis
A. Facial nerve D. Soft palate
B. Trigeminal nerve Ans:- D i.e. Soft palate
C. Glossopharyngeal nerve Ref:- Gray's 40/e p 572-68; BDC 4/e vol-111p-211,
D. Cranial accessory nerve 223; Keith Moore 6/e p 938, 941, 1028, 1037; Snell's
9/e p 648, 635
D Ref: Gray’s Anatomy 39/e, p. 558 Explanation:-
- All muscles of pharynx ie Superior, middle
& inferior constrictor,
2. Cranial accessory nerve supplies Palato/Salpingo/Crico-pharyngeus except
A. Sternomastoid stylopharyngeus are supplied by
B. Trapezius Pharyngeal plexus; Stylopharyngeus is
C. Splenius capitis supplied by Glossopharyngeal nerve.
D. Soft palate - All muscles of soft palate i.e. Palato

D Ref: Gray’s Anatomy 38/e, p. 558 glossus, Palatopharyngeus, musculus


uvulae & Levator veli palatini except
tensor veli palatini are supplied by
3. Cranial part of spinal accessory nerve supplies
pharyngeal plexus; Tensor veli palatini is
A. Sternocleidomastoid
supplied by nerve to medial pterygoid
B. Levator scapulae
mandibular nerve.
C. Superior constrictor
- All muscles of larynx ie Oblique &
D. Styloglossus
transverse arytenoids, thyroarytenoid
Ans:- C i.e. Superior Constrictor
(vocalis) & thyroepiglottic, Lateral &
4. Muscles spared by complete transaction of cranial part
posterior crico arytenoids are supplied by
of accessory nerve
Recurrent laryngeal nerve; except
A. Cricopharyngeus
Cricothyroid which is supplied by
B. Palatopharyngeus
External laryngeal nerve.
C. Stylopharyngeus
D. Salpingopharyngeus
8. Lesion of cranial part of XI nerve cause paralysis of
Ans:- C i.e. Stylopharyngeus
A. Sternocleidomastoid muscle
B. Trapezius muscle
5. After existing from skull the vagus is joined by
C. Stylopharyngeus muscle
A. Glossopharyngeal nerve
D. Pharyngeal constrictors
B. Spinal accessory nerve
Ans:- D i.e. Pharyngeal
C. Cranial accessory nerve
D. None of the above
9. A 43- year old woman came with a large abscess in the
C Ref: Gray’s Anatomy 39/e, p. 557 middle of the right posterior triangle of the neck. The
physician incised and drained the abscess. Five days
6. Cranial part Accessory nerve supplies all palatal later the patient noticed the she could not extend her
muscles except right hand above her head to brush her hair. Which of
A. Palate glossus the following are the signs and symptoms of
B. Palate pharyngeus additional harm
C. Tensor veli palate A. Damage to scalenus medius
D. Levator palate B. Injury to suprascapular nerve
Ans:- C i.e. Tensor veli palate C. Cut to spinal part of accessory nerve
D. Spread to infection to shoulder joint
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Ans:- C i.e. Cut to spinal part of accessory nerve D. Fibres of the nerve derived from nucleus
Ref:- BDC 111/4 th /71,72,198&; BDC 1/4 /76;
th ambiguous innervate the palatal muscles except
Surgical anatomy by Lee MC Gregor 12th/439,438 tensor veli palatini
Explanation:- Essentials of Human Anatomy, 3/e,
C
Inability 'to raise arm above the level of head A.K Datta vol 4, p. 262
following surgical procedure or the posterior
triangle suggests the diagnosis of injury to spinal HYPOGLOSSAL NERVE (XII)
part of accessory nerve.
Over head abduction i.e. abduction in the range of 120° to 1. Hypoglossal nerve is
180° (above head to brush hair) Occurs at the Scapulo
thoracic linkage and is aided by upward rotation of Scapulae A. Purely sensory
by the action of trapezius and serratus anterior. Trapezius is B. Purely motor
supplied by the spinal part of the accessory nerve which C. Mixed
runs in the middle of the roof of the posterior triangle D. Spinal nerve
Ans: B
10. Wry neck or torticollis is caused by Ref: Cunningham’s Manual of Practical
A. Irritation of vagus Anatomy, Vol. III, 15/E, p. 86
B. Irritation of spinal accessory 2. Hypoglossal nerve supplies all the
C. Irritation of cranial accessory muscles EXCEPT
D. Irritation of recurrent laryngeal A. Styloglossus
B Ref: Gray’s Anatomy 39/e, p. 558 B. Stylopharyngeus
C. Palatoglossus
D. Genioglossus
11. Following is true about the spinal root of
Ans: C
accessory nerve EXCEPT
Ref: BD Chaursia, 1/E, p. 297
A. It is formed by fibres from cell bodies in the anterior
horn of upper six segments of cervical part of spinal
3. The sensory supply of the palate is through all of
cord
the following, except
B. They emerge as series of roots from the lateral
A. Facial nerve
surface of spinal cord posterior to the denticulate
B. Hypoglossal nerve
ligament
C. Glossopharyngeal nerve
C. A single nerve formed enters through the jugular
D. Maxillary division of trigeminal nerve
foramen into the cranial cavity to join with the
Ans:- B i.e. Hypoglossal nerve
cranial root of accessory nerve
Explanation:-
D. It supplies sternocleidomastoid and trapezium
Palate is supplied by trigeminal (maxillary,
muscles
mandibular), facial & glossopharyngeal nerves.
Ref: Essentials of Human Anatomy,
C
3/e, A.K Datta vol 4, p. 263
4. All are supplied by Ansa cervicalis except
A. Thyrohyoid
12. Following is true about cranial root of accessory nerve
B. Sternothyroid
EXCEPT
C. Sternohyoid
A. It joins the vagus nerve superior to the inferior
D. Inferior belly of omohyoid
vagal ganglion
Ans:-A i.e. Thyrohyoid
B. It contains special visceral efferent and general
Explanation:-
visceral efferent components
Thyrohyoid and Geniohyoid are supplied by first
C. It joins with spinal root of accessory nerve after
cervical nerve through hypoglossal nerve.
emerging through the jugular foramen

5. The ansa cervicalis innerates which muscle


A. Mylohyoid
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B. Cricothyroid 10. Hypoglossal nerve crosses loop of which of the


C. Stylohyoid arteries
D. Sternohyoid A. External carotid artery
Ans:-D i.e. Sternohyoid B. Lingual artery
Ref:- BDC 4/e Vol III p-130; Last’s Anatomy 11/e p C. Facial artery
356,345-346 D. Ascending pharyngeal

B Ref: Gray’s Anatomy 39/e, p. 546


6. All the following cranial nerves transmit
taste sensation to the brain except
A. Facial nerve
11. In a patient it is noticed that when he
B. Glossopharyngeal nerve
protrudes his tongue is deviates to the left.
C. Vagus nerve
The nerve damaged is:
D. Hypoglossal nerve
A. Left hypoglossal
Ans: D. Hypoglossal nerve
B. Left glossopharyngeal
Ref: BD Chaurasia 5/E, vol 3, p. 231
C. Right hypoglossal
D. Right glossopharyngeal

7. The Hypoglossal nerve provides C Ref: Gray’s Anatomy 39/e, p. 559


A. Motor innervations to styloglossus and hyoglossus 12. Following nerves have general somatic efferent
muscles only component except
B. Motor innervations to all the muscles of the tongue A. Trochlear
both intrinsic and extrinsic B. Abducens
C. Sensory innervations to the posterior third of the C. Glossopharyngeal
tongue D. Hypoglossal
D. Sensory innervations to the anterior two-thirds of Inderbir Singh, Human Embryology,
the tongue D
8/e, p. 299
B Ref: Gray’s Anatomy 39/e, p .588

8. The hypoglossal nerve lies to hyoglossus and


genioglossus muscles IMPORTANT CRANIAL NERVE REFLEXES

A. Superior
B. Latero inferior 1. Afferent component of corneal reflex is mediated

C. Deep by

D. Anterior A. Vagus nerve


B. Facial nerve
A Ref: Gray’s Anatomy 39/e, p. 585
C. Trigeminal nerve
D. Glossopharyngeal nerve
9. The hypoglossal nerve supplies Ref: Snell’s Clinical Neuroanatomy,
C
A. All the intrinsic muscles of the tongue except the 5/e, p. 337
palatoglossus
B. All intrinsic and extrinsic muscles of tongue except 2. Gag reflex is lost due to paralysis of
hyoglossus A. V nerve
C. All intrinsic and extrinsic muscles of tongue except B. VII nerve
palatoglossus C. IX nerve
D. All the muscles of tongue and floor of mouth D. XII nerve
Ref: Snell’s Clinical Neuroanatomy,
C
C Ref: Gray’s Anatomy 39/e, p. 588 5/e, p. 360

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