Head & Neck Practice Questions

Q: A histology slide from a routine autopsy is shown. The image reveals a tubular structure whose wall contains an inner oblique, middle circular, and outer longitudinal smooth muscle layer. The mucosa is lined by simple columnar epithelium with prominent gastric pits, and the lamina propria contains straight tubular glands extending the full depth of the mucosa with parietal (oxyntic) cells and chief cells that open into the base of the pits. The submucosa is unremarkable. Which region of the gastrointestinal tract does this specimen most likely represent?

Fundus of the stomach. ***Fundus of the stomach*** - The presence of **parietal (oxyntic) cells** and **chief cells** within straight tubular glands that extend the full depth of the mucosa is characteristic of the fundic and body regions of the stomach. - The stomach is unique in the gastrointestinal tract for having a three-layered **muscularis externa** consisting of an **inner oblique**, **middle circular**, and **outer longitudinal** smooth muscle layer. *Cardiac region of the stomach* - The cardia is primarily characterized by **mucous-secreting glands** that are shorter and often branched compared to the fundus. - **Parietal and chief cells** are typically absent or very sparse in this specific region of the stomach. *Pyloric region of the stomach* - The pylorus features very **deep gastric pits** (occupying about half the mucosal thickness) and short, coiled, branched glands. - The glands in this region consist almost entirely of **mucous cells** and G-cells, lacking the high density of **parietal and chief cells** found in the fundus. *First part of the duodenum* - The duodenum is identified by the presence of **Brunner's glands** in the submucosa, which were explicitly described as unremarkable in this specimen. - It lacks an **inner oblique muscle layer** and features a mucosa with **villi and crypts of Lieberkuhn** rather than gastric pits and fundic glands. *Gastroesophageal junction* - This region marks a sharp transition from **stratified squamous epithelium** of the esophagus to the **simple columnar epithelium** of the stomach. - The esophageal side would contain **esophageal cardiac glands** in the lamina propria and would not demonstrate the triple-layered smooth muscle architecture of the gastric wall.

Q: Impaired gag reflex is seen due to a lesion in which cranial nerves?

CN IX & X. ***Correct: CN IX & X*** The **gag reflex (pharyngeal reflex)** is a protective reflex involving two cranial nerves: - **Afferent limb**: **CN IX (Glossopharyngeal nerve)** provides sensory innervation to the posterior third of the tongue, oropharynx, and pharyngeal walls - **Efferent limb**: **CN X (Vagus nerve)** provides motor innervation to the pharyngeal muscles (via the pharyngeal plexus) that contract during the reflex **Clinical correlation**: Testing the gag reflex helps assess brainstem function and the integrity of CN IX and X. Impairment suggests lesions affecting these nerves or their nuclei in the medulla. *Incorrect: CN V & VI* - CN V (Trigeminal) provides facial sensation and motor to muscles of mastication, not involved in gag reflex - CN VI (Abducens) controls lateral rectus muscle for eye abduction *Incorrect: CN X & XI* - While CN X is involved, CN XI (Accessory nerve) innervates sternocleidomastoid and trapezius muscles, not pharyngeal muscles *Incorrect: CN VII & VIII* - CN VII (Facial) controls facial expression and taste from anterior 2/3 of tongue - CN VIII (Vestibulocochlear) is involved in hearing and balance, not the gag reflex *Incorrect: CN XI & XII* - CN XI (Accessory) innervates SCM and trapezius - CN XII (Hypoglossal) provides motor to intrinsic and extrinsic tongue muscles, not pharyngeal muscles involved in gag reflex

Q: Which tongue papillae do not have taste buds?

Filiform. ***Filiform*** - **Filiform papillae** are the most abundant type of papillae on the tongue and are responsible for the **mechanical action of gripping food**, due to their cone-shaped, abrasive structure of keratinized epithelium. - Unlike other papillae, they **lack taste buds** and thus do not play a role in taste sensation. *Fungiform* - **Fungiform papillae** are mushroom-shaped and are scattered among the filiform papillae, primarily on the tip and sides of the tongue. - These papillae **contain taste buds** on their superior surface and are involved in sensing taste stimuli. *Circumvallate* - **Circumvallate papillae** are large, dome-shaped structures arranged in a V-shape at the back of the tongue. - They are surrounded by a trench into which salivary glands empty, and their walls contain a **large number of taste buds**. *Foliate* - **Foliate papillae** are leaf-like folds located on the lateral margins of the posterior tongue. - They are **well-developed in young children** and contain taste buds, though they tend to degenerate with age. *Conical* - **Conical** is not a recognized classification of tongue papillae. While filiform papillae have a conical (cone-shaped) structure, "conical papillae" is not an anatomical term used to describe a distinct type of papilla.

Question 1

During a routine appendectomy in a 19-year-old man, the surgeon identifies a 5 cm blind-ended diverticulum on the antimesenteric border of the ileum, approximately 60 cm proximal to the ileocecal valve. Histological examination of the resected specimen reveals heterotopic gastric mucosa within the diverticulum wall alongside normal ileal mucosa and a well-defined muscularis propria continuous with the bowel wall. Which developmental structure failed to obliterate to produce this anomaly?

Accepted Answer

Vitelline (omphalomesenteric) duct connecting the midgut to the yolk sac

Answer

Allantois connecting the bladder to the umbilicus

Answer

Processus vaginalis of the peritoneum descending with the testis

Answer

Umbilical vein within the falciform ligament

Answer

Dorsal mesentery of the midgut during intestinal rotation at week 10

Question 2

A histology slide from a routine autopsy is shown. The image reveals a tubular structure whose wall contains an inner oblique, middle circular, and outer longitudinal smooth muscle layer. The mucosa is lined by simple columnar epithelium with prominent gastric pits, and the lamina propria contains straight tubular glands extending the full depth of the mucosa with parietal (oxyntic) cells and chief cells that open into the base of the pits. The submucosa is unremarkable. Which region of the gastrointestinal tract does this specimen most likely represent?

Accepted Answer

Fundus of the stomach

Answer

Cardiac region of the stomach

Answer

Pyloric region of the stomach

Answer

First part of the duodenum

Answer

Gastroesophageal junction

Question 3

Impaired gag reflex is seen due to a lesion in which cranial nerves?

Accepted Answer

CN IX & X

Answer

CN V&VI

Answer

CN X & XI

Answer

CN VII & VIII

Answer

CN XI & XII

Question 4

Which tongue papillae do not have taste buds?

Accepted Answer

Filiform

Answer

Fungiform

Answer

Circumvallate

Answer

Foliate

Answer

Conical

Question 5

Match the following nerves to their respective areas of supply to the auricle

Accepted Answer

A - Auriculotemporal, B - Greater auricular, C - Vagus, D - Lesser occipital

Answer

A - Greater auricular, B - Auriculotemporal, C - Lesser occipital, D - Vagus

Answer

A - Auriculotemporal, B - Lesser occipital, C - Greater auricular, D - Vagus

Answer

A - Auriculotemporal, B - Lesser occipital, C - Vagus, D - Greater auricular

Answer

A - Vagus, B - Greater auricular, C - Auriculotemporal, D - Lesser occipital

Head & Neck — MCQs

Head & Neck — MCQs

On this page

Practice by Chapter

Want unlimited practice?