USMLE1- Practice questions Cranial Nerves

Cranial Nerves:Which of the following cranial nerves is necessary for horizontal conjugate movements of the eyes?

a.       III

b.      IV

c.       VI

d.      Both A and B

e.       Both A and C –Occulomotor & Abducens

2.      Which of the following cranial nerves is necessary for elevation of the eyeball?

a.       III- Occulomotor

b.      IV

c.       VI

d.      V

e.       None of the above

3.      Which of the following combinations of extraocular muscle and cranial nerve of supply are involved in mediating depression or downward movements of the eyeball?

a.       superior oblique - Nerve III

b.      inferior oblique - Nerve IV

c.       inferior rectus - Nerve VI

d.      inferior oblique - Nerve IV

e.       superior oblique - Nerve IV-Trochlear

4.      Which of the following is NOT a function of cranial nerve III?

a.       elevation of eyes

b.      adduction of eyes

c.       constriction of pupil

d.      dilatation of pupil

e.       changing the shape of the lens

5.      Which of the following ganglia is involved in mediating pupillary light reflex?

a.       ciliary ganglion

b.      celiac ganglion

c.       trigeminal ganglion

d.      pterygopalatine ganglion

e.       none of the above

6.      Which of the following in NOT a sign/symptom of dysfunction of cranial nerve III?

a.       constricted pupil (miosis)

b.      downward and outward deviation of the eye ball

c.       loss of pupillary light reflex

d.      ptosis (drooping of the upper lid)

e.       none of the above

7.      Which of the following cranial nerves innervate smooth muscles?

a.       IX

b.      V

c.       VII

d.      Both A and C

e.       III-occulomotor

8.      Which of the following muscles remain functional after a complete interruption of cranial nerve III?

a.       ciliary muscle

b.      lateral rectus

c.       superior oblique

d.      superior rectus

e.       Both B and C

9.      Which of the following cranial nerves has the longest intracranial course (between points of attachment to the brain stem and exit through its cranial foramen)?

a.       III

b.      V

c.       VI -abducens

d.      VII

e.       IX

10.  Which of the following is a TRUE statement?

a.       all cranial nerves carry motor, sensory and parasympathetic fibers

b.      all cranial nerves have sensory ganglia attached to them

c.       cranial nerves carry sympathetic preganglionic fibers

d.      all spinal nerves carry sensory and motor fibers

e.       all spinal nerves carry parasympathetic fibers

11.  Trigeminal nerve:

a.       is a mixed cranial nerve with both motor and sensory functions

b.      has a sensory ganglion

c.       innervates the muscles of mastication

d.      does not carry preganglionic parasympathetic fibers

e.       all of the above are true

12.  Which of the following cranial nerves is/are closely related to the cavernous sinus?

a.       III -occulo

b.      VI -abducent

c.       IV -trochlear

d.      ophthalmic and maxillary divisions of V-trigeminal

e.       all of the above

13.  The ophthalmic nerve:

a.       gives rise to branches which supply the cornea

b.      innervates the muscles of mastication

c.       is necessary for the motor response of the corneal reflex

d.      innervates the buccinator muscle

e.       provides sensory innervation to the skin of the cheek

14.  The maxillary division of trigeminal nerve:

a.       passes through the pterygopalatine fossa

b.      becomes the infraorbital nerve

c.       supplies the skin of the cheek, lower eyelid and upper lip

d.      supplies the lining of the maxillary air sinus

e.       all of the above are true

15.  Damage to the motor fibers in the trigeminal nerve may cause:

a.       flattening of the side of the jaw due to atrophy of the masseter muscle

b.      difficulty in closing the eyes

c.       slight deviation of the jaw toward the affected side when the mouth is opened

d.      Both A and B

e.       Both A and C

16.  Mandibular division of the trigeminal nerve conveys cutaneous sensory information from:

a.       the upper lip

b.      the lower lip

c.       the bony part of the cheek

d.      Both A and C

e.       Both B and C

17.  Which of the following is NOT supplied by branches of the mandibular division of V:

a.       gums and teeth of the lower jaw

b.      anterior two-thirds of the tongue

c.       muscles of mastication

d.      skin over the angle of the mandible  

e.       e. mucous membrane lining the cheek

18.  Facial nerve:

a.       enters the internal auditory meatus

b.      courses in the facial canal in the petrous temporal bone in relation to the middle ear cavity

c.       exits from the skull through the stylomastoid foramen

d.      enters the substance of the parotid salivary gland

e.       all of the above are true

19.  Which of the following cranial nerves is likely to be damaged during surgery on middle ear and mastoid antrum?

a.       V

b.      VI

c.       VII -facial

d.      X

e.       None of the above

20.  Which of the following is NOT supplied by the vagus, along with the cranial accessory?

a.       constrictor muscles of the pharynx

b.      muscles of the soft palate

c.       muscles of the larynx

d.      mucous membrane of the larynx

e.       mucous membrane of the nasal cavity

21.  The recurrent laryngeal branch of the vagus:

a.       arises in the thorax on the left side

b.      is found in the groove between the trachea and the esophagus in the neck

c.       supplies all muscles of the larynx except the cricothyroid

d.      only A and C are correct

e.       A, B and C are correct

22.  The cranial division of the accessory nerve:

a.       arises from the spinal cord

b.      contains parasympathetic fibers which innervate the heart and other viscera

c.       joins the vagus and is distributed through it to the skeletal muscles of the larynx, soft palate and pharynx

d.      is found in the roof of the posterior triangle

e.       supplies the sternocleidomastoid muscle

23.  A normal gag reflex is dependent on the intactness of the following nerves:

a.       V

b.      IX

c.       X and cranial XI

d.      Both A and B

e.       Both B and C

24.  You are testing palatal movements in a patient. When the patient is asked to say "Ah", the right side of the palate is found to be at a lower level than the left and the uvula is deviated toward the left. This patient is likely to have a lesion of the:

a.       right vagus and cranial accessory

b.      left vagus and cranial accessory

c.       right glossopharyngeal nerve

d.      left glossopharyngeal nerve

e.       none of the above

25.  Which of the following cranial nerves carry parasympathetic preganglionic fibers?

a.       III -occulo

b.      VII -facial

c.       IX -glossopharyngeal

d.      X -vagus

e.       all of the above

26.  Which of the following muscles is innervated by parasympathetic postganglionic fibers?

a.       ciliary muscle

b.      superior rectus

c.       sphincter pupillae

d.      dilator pupillae

e.       both A and C

27.  A complete interruption of the right cranial nerve VI will result in:

a.       paralysis of the left lateral rectus

b.      inability to abduct the right eye

c.       diplopia in looking to the left

d.      inability to adduct the right eye

e.       all of the above

28.  Which of the following can produce ptosis (drooping of upper eyelid)?

a.       loss of innervation of the levator palpebrae superioris

b.      loss of function of cranial nerve III

c.       loss of sympathetic innervation of the eye

d.      paralysis of orbicularis oculi muscle

e.       all of the above except D

29.  Pupillary dilation results from:

a.       contraction of dilator pupillae

b.      activation of sympathetic preganglionic neurons in the spinal cord

c.       activation of sympathetic postganglionic fibers arising from the superior cervical ganglion

d.      release of norepinephrine from nerves which innervate the dilator pupillae

e.       all of the above

30.  Which of the following cranial nerves carry motor fibers to skeletal muscles?

a.       facial

b.      hypoglossal

c.       vagus

d.      mandibular branch of trigeminal

e.       all of the above

31.  Which of the following cranial nerves travel through the superior orbital fissure?

a.       III –occulo

b.      IV -troch

c.       ophthalmic division of V

d.      maxillary division of V

e.       all of the above except D

32.  Ophthalmic division of V:

a.       passes through the optic foramen

b.      enters the orbit through the inferior orbital fissure

c.       supplies skeletal muscles in the orbit

d.      is the major sensory nerve to the eye by way of its nasociliary branch

e.       all of the above

33.  The frontal nerve:

a.       divides into supraorbital and supratrochlear branches

b.      supplies the skin of the forehead

c.       supplies the frontal air sinus

d.      is a sensory nerve

e.       all of the above

34.  Cutaneous distribution of the maxillary nerve includes:

a.       upper eyelid

b.      lower eyelid

c.       lower lip

d.      bridge of the nose

e.       all of the above

35.  Branches of the trigeminal nerve supply:

a.       Meninges

b.      mucous lining of nasal cavities and paranasal air sinuses

c.       cornea

d.      mucosa of the anterior two-thirds of the tongue

e.       all of the above

36.  Branches of the mandibular division of the trigeminal nerve supply:

a.       masseter

b.      buccinator

c.       medial and lateral pterygoids

d.      orbicularis oculi

e.       A and C

37.  The corneal reflex is a test for the integrity of:

a.       ophthalmic division of V

b.      cranial nerve III

c.       cranial nerve VII

d.      both (a) and (b)

e.       both (a) and (c)

38.  The mandibular nerve:

a.       passes through the foramen spinosum

b.      is a purely sensory nerve, with no motor components

c.       provides sensory innervation to the posterior third of the tongue

d.      passes through the pterygopalatine fossa

e.       its lingual branch carries the chorda tympani branch of nerve VII

39.  Which of the following types of fibers is/are NOTcontained in the facial nerve?

a.       motor

b.      parasympathetic preganglionic

c.       special sensory from taste buds

d.      general sensory from the facial skin

e.       general sensory from the mucous membranes

40.  Parasympathetic fibers contained in the facial nerve are responsible for the innervation of:

a.       submandibular salivary gland

b.      lacrimal gland

c.       sublingual salivary gland

d.      parotid salivary gland

e.       all of the above except D

41.  Inflammatory reaction confined to an area around the stylomastoid foramen is one of the conditions that leads to a clinical entity referred to as "Bell's palsy". This is likely to manifest as:

a.       difficulty in opening the eyes

b.      absence of wrinkling of the forehead

c.       complete lack of secretion of saliva

d.      inability to perceive taste sensation from the anterior two-thirds of the tongue

e.       all of the above

42.  Loss of taste sensation at the tip of the tongue indicates an involvement of:

a.       branches of the facial nerve in the parotid gland

b.      chorda tympani branch of facial nerve

c.       the facial nerve at the level of the stylomastoid foramen

d.      the facial nerve in the cranial cavity before it enters the facial canal

e.       Both B and D

43.  Glossopharyngeal nerve innervates:

a.       taste buds in the posterior third of the tongue

b.      general sensory receptors in the posterior third of the tongue

c.       stylopharyngeus muscle

d.      baroreceptors in the carotid sinus                 

e.       e. all of the above

44.  Sensory innervation of the mucous membrane of the larynx is provided by:

a.       the glossopharyngeal nerve

b.      trigeminal nerve

c.       the spinal accessory nerve

d.      the vagus

e.       all of the above

45.  On asking a patient to protrude her tongue, you observe that the tongue deviates to the right side. This patient is likely to have:

a.       a paralysis of the right genioglossus muscle

b.      a complete interruption of the right hypoglossal nerve

c.       wasting (atrophy) of the right half of the tongue

d.      a normal left hypoglossal nerve

e.       all of the above

46.  Which of the following is correct regarding the larynx?

a.       mucous membrane below the vocal cords is supplied by the internal laryngeal branch of vagus

b.      external laryngeal branch supplies the cricothyroid muscle

c.       all muscles other than the cricothyroid are supplied by the internal laryngeal branch

d.      one muscle is supplied by the glossopharyngeal nerve

e.       sensory innervation is in part provided by the glossopharyngeal nerve

47.  Which of the following combinations of skeletal muscle and its nerve of supply is/are NOT correct?

a.       buccinator - facial nerve

b.      lateral cricoarytenoid - vagus

c.       genioglossus - hypoglossal nerve

d.      mylohyoid- cervical spinal nerve

e.       infrahyoid muscles- hypoglossal nerve

48.  Which of the following cranial nerves is/are responsible for initiating reflexes resulting from the stimulation of receptors in the carotid body and sinus?

a.       IX –the carotid sinus is thickening of wall of internal carotid artery, near common carotid. Baroreceptors fire when pressure in sinus is changed.

b.      V

c.       XI

d.      VII

e.       all of the above

49.  Which of the following branches of cranial nerves contains preganglionic parasympathetic fibers?

a.       chorda tympani

b.      greater superficial petrosal

c.       lacrimal

d.      both a and b

e.       All of the above

50.  Which of the following cranial nerves carry taste sensation?

a.       VII -facial

b.      IX -glosso

c.       X -vagus

d.      XI -accessory

e.       all of the above except D

1. A&C,  2. E,  3. E,  4. D,  5. A,  6.A,  7.E,  8.E,  9.C,  10. D,  11.E, 12. E, 13.A, 14. E, 15.E, 16. B, 17. D, 18. E, 19. C, 20. E, 21. E, 22. C, 23. E,  24. A,  25. E,  26. E,  27. B,  28. E,  29. E,  30. E,  31.E,  32. D,  33. E,  34. B, 35.E, 36. E, 37. E, 38. E, 39. D, 40. E, 41. B, 42. E, 43. E, 44. D, 45. E, 46. B, 47. D, 48. A, 49. E, 50. E.