Head and Neck Anatomy Practice Questions
20 free Head and Neck Anatomy practice questions for the USMLE Step 1. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
A patient develops hoarseness after thyroid surgery. Injury to which nerve is the most likely cause?
- A Internal branch of superior laryngeal nerve
- B External branch of superior laryngeal nerve
- C Recurrent laryngeal nerve
- D Glossopharyngeal nerve
Correct answer: Recurrent laryngeal nerve
The recurrent laryngeal nerve innervates all intrinsic laryngeal muscles except cricothyroid. Damage results in hoarseness due to impaired vocal cord movement.
A patient presents with inability to retract the mandible. Dysfunction of which muscle is most likely responsible?
- A Lateral pterygoid (jaw protrusion)
- B Masseter (jaw elevation)
- C Temporalis (posterior fibers)
- D Medial pterygoid (jaw elevation)
Correct answer: Temporalis (posterior fibers)
The posterior fibers of temporalis are the primary retractors of the mandible. Injury impairs retraction while leaving elevation mostly intact.
A dentist accidentally anesthetizes the lingual nerve. Which taste sensation is most likely lost?
- A Taste to anterior two-thirds of the tongue
- B Taste to posterior third of the tongue
- C Taste to epiglottis
- D Taste from soft palate
Correct answer: Taste to anterior two-thirds of the tongue
The lingual nerve carries general sensation and receives taste fibers from chorda tympani for the anterior two-thirds of the tongue. Anesthesia blocks both modalities.
A blow to the lateral skull injures the pterion. Rupture of which artery is a serious concern?
- A Middle meningeal artery
- B Anterior cerebral artery
- C Superficial temporal artery
- D Occipital artery
Correct answer: Middle meningeal artery
The middle meningeal artery lies deep to the pterion and can rupture with trauma. This leads to epidural hematoma.
A patient is unable to shrug the shoulder after neck surgery. Which muscle has lost its innervation?
- A Levator scapulae
- B Trapezius
- C Sternocleidomastoid
- D Rhomboid major
Correct answer: Trapezius
The trapezius is innervated by the spinal accessory nerve (CN XI). Its injury causes shoulder droop and impaired shrugging.
A patient presents with dry eyes due to loss of parasympathetic fibers to the lacrimal gland. These fibers travel through which nerve?
- A Zygomatic nerve
- B Chorda tympani
- C Greater petrosal nerve
- D Nasociliary nerve
Correct answer: Greater petrosal nerve
Parasympathetic fibers to the lacrimal gland originate from the greater petrosal nerve (branch of CN VII). They synapse in the pterygopalatine ganglion.
A patient cannot look laterally with the right eye. Which nerve is likely damaged?
- A Oculomotor nerve
- B Trochlear nerve
- C Abducens nerve
- D Optic nerve
Correct answer: Abducens nerve
The abducens nerve (CN VI) innervates the lateral rectus muscle responsible for abduction of the eye. Damage prevents lateral gaze.
An infection in the danger triangle of the face can spread intracranially through which venous structure?
- A Internal jugular vein
- B Facial vein
- C Retromandibular vein
- D Subclavian vein
Correct answer: Facial vein
The facial vein communicates with the cavernous sinus through the superior ophthalmic vein. This allows infection to spread to the cranium.
A patient has tongue deviation to the right when protruded. Which nerve is damaged?
- A Right glossopharyngeal nerve
- B Left glossopharyngeal nerve
- C Right hypoglossal nerve
- D Left hypoglossal nerve
Correct answer: Right hypoglossal nerve
The tongue deviates toward the side of hypoglossal nerve injury due to unopposed action of the contralateral genioglossus. This indicates right-sided damage.
A patient experiences loss of sensation over the angle of the mandible. Which nerve is responsible for innervation of this area?
- A Auriculotemporal nerve
- B Great auricular nerve
- C Inferior alveolar nerve
- D Buccal nerve
Correct answer: Great auricular nerve
The great auricular nerve (C2–C3) supplies skin over the parotid region and angle of the mandible. It is commonly injured in surgical procedures in this region.
A patient develops facial paralysis after parotid gland surgery. Which movement will be most compromised?
- A Elevation of the mandible
- B Sensation to the cheek
- C Closing the eyelids
- D Tongue protrusion
Correct answer: Closing the eyelids
The facial nerve controls orbicularis oculi for eyelid closure. Injury during parotid surgery can cause inability to close the eye.
A blowout fracture of the orbit most commonly affects which structure?
- A Lateral orbital wall
- B Superior orbital plate
- C Orbital floor
- D Medial orbital wall
Correct answer: Orbital floor
The orbital floor (maxillary bone) is the thinnest and most commonly fractured in blowout injuries. It may entrap the inferior rectus muscle.
Swelling in the submandibular region compresses the structure that drains the submandibular gland. Which duct is this?
- A Stensen duct
- B Wharton duct
- C Parotid duct
- D Rivinus ducts
Correct answer: Wharton duct
Wharton duct drains the submandibular gland and opens near the lingual frenulum. Compression causes salivary retention.
Damage to the glossopharyngeal nerve would impair which reflex?
- A Corneal reflex (afferent)
- B Pupillary reflex (efferent)
- C Gag reflex (afferent)
- D Jaw jerk reflex
Correct answer: Gag reflex (afferent)
CN IX is the afferent limb of the gag reflex. Damage causes loss of the gag response on the affected side.
A patient has difficulty opening the mouth after a mandibular fracture. Which muscle is primarily responsible for depressing the mandible?
- A Masseter
- B Lateral pterygoid
- C Temporalis
- D Medial pterygoid
Correct answer: Lateral pterygoid
The lateral pterygoid opens the jaw by protruding and depressing the mandible. It is the only major muscle of mastication that opens the mouth.
A surgeon ligates the external carotid artery. Which branch must be preserved to maintain scalp blood supply?
- A Superior thyroid artery
- B Lingual artery
- C Superficial temporal artery
- D Facial artery
Correct answer: Superficial temporal artery
The superficial temporal artery supplies the scalp and must be preserved during ligation procedures. It is a terminal branch of the external carotid.
A patient has decreased tear production. Which ganglion is responsible for the parasympathetic innervation of the lacrimal gland?
- A Otic ganglion
- B Submandibular ganglion
- C Ciliary ganglion
- D Pterygopalatine ganglion
Correct answer: Pterygopalatine ganglion
The pterygopalatine ganglion receives parasympathetic fibers from the greater petrosal nerve and sends them to the lacrimal gland. Damage reduces tear secretion.
A patient with an upper eyelid droop has impaired function of which muscle?
- A Superior tarsal muscle
- B Superior rectus
- C Levator palpebrae superioris
- D Orbicularis oculi
Correct answer: Levator palpebrae superioris
Levator palpebrae superioris elevates the upper eyelid and is innervated by CN III. Damage produces ptosis.
A child presents with recurrent middle ear infections. Which structure connects the nasopharynx to the middle ear and equalizes pressure?
- A External auditory canal
- B Eustachian tube
- C Oval window
- D Round window
Correct answer: Eustachian tube
The Eustachian (pharyngotympanic) tube connects the middle ear to the nasopharynx. It helps equalize pressure but can allow infections to spread.
A patient has nasal septal deviation causing difficulty breathing. Which structure forms the inferior portion of the nasal septum?
- A Ethmoid bone (perpendicular plate)
- B Vomer
- C Palatine bone
- D Nasal bone
Correct answer: Vomer
The vomer forms the inferior and posterior part of the nasal septum. Deviations often involve this structure.