Multiple Choice Questions MCQ

Question 43# Print Question

Which one of the following statements is false regarding head and neck anatomy?

A. Omohyoid originates from the upper border of the scapula and raises the hyoid bone

B. The blood supply of omohyoid is the inferior thyroid artery

C. A level III neck dissection involves the removal of nodes which includes the middle jugular group

D. Trapezius forms the posterior boundary of a level V neck dissection

E. Bocca is often credited as the first to describe the functional neck dissection in the 1960s

Omohyoid originates from the upper border of the scapula and raises the hyoid bone. A is false. Omohyoid originates from the upper border of the scapula and has two separate insertions via the intermediate tendon onto the clavicle and first rib, and the hyoid bone lateral to the sternohyoid muscle. The blood supply to omohyoid is via the inferior thyroid artery. The two functions of omohyoid are to depress the hyoid and to tense the deep cervical fascia.

To describe the lymph nodes of the neck for neck dissection, the neck is divided into six areas called levels. The levels are identified by Roman numerals, increasing towards the chest. A further Level VII to denote lymph node groups in the superior mediastinum is no longer used. Instead, lymph nodes in other non-neck regions are referred to by the name of their specific nodal groups.

III includes lymph nodes of the middle jugular group. This level is bounded by the inferior border of the hyoid (superiorly) and the inferior border of the cricoid (inferiorly), the posterior border of the sternohyoid (anteriorly) and the posterior border of the SCM (posteriorly).

Level V includes the posterior compartment lymph nodes. This compartment is bounded by the clavicle (inferiorly), the anterior border of trapezius (posteriorly), and the posterior border of the SCM (anteriorly). It is divided into sublevels VA (lying above a transverse plane marking the inferior border of the anterior cricoid arch) and VB (below the aforementioned plane).

Bocca popularised the functional neck dissection in the 1960s, and is often referred to as the originator of the technique; however, it appears that other surgeons were performing such dissections before him.

References:

Ferlito A, Rinaldo A. Osvaldo Suárez: often-forgotten father of functional neck dissection (in the non-Spanish-speaking literature). Laryngoscope 2004; 114(7): 1177-8.
Bocca E. Supraglottic laryngectomy and functional neck dissection. J Laryngol Otol 1966; 80(8): 831-8.

Question 41# What method did Sushruta recommend for nasal reconstruction?
A. Scalp flap
B. Forehead flap
C. Arm flap
D. Skin graft
E. Cheek flap
Cheek flap. The Indian rhinoplasty uses forehead skin as did the local practitioners but Sushruta describes what we would now call a cheek advancement flap.

Question 42# Microtia is more common in:
A. Boys and On the right
B. Girls
C. On the left
D. Twins
E. Boys and On the left
Boys and on the right.

Question 44# T3 N3 M0 SCC of the alveolus of the mandibular symphysis may need the following except:
A. Free fibular osteocutaneous flap
B. Bilateral radical neck dissection with preservation of the left internal jugular vein
C. Postoperative radiotherapy
D. Marginal mandibulectomy
E. Tracheostomy
Marginal mandibulectomy. A tumour of this size with nodal spread needs segmental excision and definitive reconstruction with postoperative radiotherapy. Central tumours and those involving or crossing the midline require bilateral neck dissection.

Question 45# With regards to ptosis:
A. It can be treated with Botulinum toxin
B. It is associated with mydriasis in Horner’s syndrome
C. Gold weights are usually adequate treatment
D. Muller’s muscle may be dysfunctional
E. Iatrogenic causes are the leading cause of litigation throughout surgical practice across all specialties
Muller’s muscle may be dysfunctional.

Question 43# Which one of the following statements is false regarding head and neck anatomy?
A. Omohyoid originates from the upper border of the scapula and raises the hyoid bone
B. The blood supply of omohyoid is the inferior thyroid artery
C. A level III neck dissection involves the removal of nodes which includes the middle jugular group
D. Trapezius forms the posterior boundary of a level V neck dissection
E. Bocca is often credited as the first to describe the functional neck dissection in the 1960s
Omohyoid originates from the upper border of the scapula and raises the hyoid bone. A is false. Omohyoid originates from the upper border of the scapula and has two separate insertions via the intermediate tendon onto the clavicle and first rib, and the hyoid bone lateral to the sternohyoid muscle. The blood supply to omohyoid is via the inferior thyroid artery. The two functions of omohyoid are to depress the hyoid and to tense the deep cervical fascia. To describe the lymph nodes of the neck for neck dissection, the neck is divided into six areas called levels. The levels are identified by Roman numerals, increasing towards the chest. A further Level VII to denote lymph node groups in the superior mediastinum is no longer used. Instead, lymph nodes in other non-neck regions are referred to by the name of their specific nodal groups. III includes lymph nodes of the middle jugular group. This level is bounded by the inferior border of the hyoid (superiorly) and the inferior border of the cricoid (inferiorly), the posterior border of the sternohyoid (anteriorly) and the posterior border of the SCM (posteriorly). Level V includes the posterior compartment lymph nodes. This compartment is bounded by the clavicle (inferiorly), the anterior border of trapezius (posteriorly), and the posterior border of the SCM (anteriorly). It is divided into sublevels VA (lying above a transverse plane marking the inferior border of the anterior cricoid arch) and VB (below the aforementioned plane). Bocca popularised the functional neck dissection in the 1960s, and is often referred to as the originator of the technique; however, it appears that other surgeons were performing such dissections before him. References: Ferlito A, Rinaldo A. Osvaldo Suárez: often-forgotten father of functional neck dissection (in the non-Spanish-speaking literature). Laryngoscope 2004; 114(7): 1177-8. Bocca E. Supraglottic laryngectomy and functional neck dissection. J Laryngol Otol 1966; 80(8): 831-8.

Your-Doctor Multiple Choice Questions (MCQ)

Your-Doctor
Multiple Choice Questions (MCQ)