PROPOSED SEQS FOR THE FINAL (HEAD AND NECK REGION) STAGE.

2ND YEAR MBBS

OSTEO/ ARTHROLOGY 1 SEQ to be e!e"te# Q1) In an accident, a person got an injury on the left side of the skull with severe bleeding. X ray revealed a fracture line in the left pterion. a) What is terion! b) "ive the clinical i#portance of terion c) $sing your knowledge of anato#y give the possible clinical outco#e. Q%) & patient of '( years of age ca#e to the doctor with history of trau#a to the lower jaw and now he was unable to close his #outh after yawning. X ray revealed fracture of right side #andibular neck. )urgery was advised. a) $sing your knowledge of anato#y, suggest which structures should be preserved during surgery. b) *a#e the factors, nor#ally, preventing anterior dislocation of +,-. NE$ROLOGY 2 SEQ to be e!e"te# Q1) & ./0year0old lady presented to orthopedics depart#ent with co#plaints of constant pain in the neck. 1er neck was held rigidly and #ove#ents e2acerbated the pain. 3n further history and e2a#ination it was noted that she also has parasthesias and sensory loss over her upper li#bs. & diagnosis of cervical spondylosis 4cervical spine and intervertebral disc degeneration) was #ade. *erve roots 5%, .,6,' and 7 were believed to be involved. a) Which neck #uscles you think would show signs of weakness and wasting! b) 8raw and label the der#ato#es involved in the head and neck region. Q%) "ive an account of 9"anglion of 1ay :ever; under the following headings. a) preganglionic fibers b) <ranches Q.) & fe#ale patient of '( years of age presented with a history of sudden attacks of sharp pain lasting for %( #inutes in the region of left lower face especially by touching that side during brushing the teeth and chewing. a) Which nerve is #ost likely involved! b) =nu#erate its branches and areas of distribution. Q.) While perfor#ing dissection of the neck region, %nd year #edical students ca#e across a loop of nerve just in front of the right internal jugular vein. a) *a#e the structure they encountered. b) "ive its for#ation and distribution.

Q6) & patient is a diagnosed case of pancoast tu#or of the left lung 4ape2 of the lung). 1e presented with co#plaints of left sided partial drooping of upper0lid, constricted pupil, loss of sweating on the face and sunken eyeball. $sing your knowledge of anato#y> a) *a#e the structure co#pressed by the tu#or. b) -ustify the above0#entioned signs and sy#pto#s. MYOLOGY 2 SEQ to be e!e"te# Q1) & 1/0year0old ninja had a stab would injury with a sharp sword at the right side of his neck. +he doctor told that it was deep wound involving vital structures in the posterior triangle of the neck. a) "ive the boundaries of the posterior triangle. b) =nu#erate the structures liable to be da#aged in this case Q%) =nu#erate the fle2ors of the neck. "ive their origin and insertion in a tabulated for#. Q.) & 6.0year0old wo#an was seen in the e#ergency dept. with a large, red, hot and fluctuant abscess in the #iddles of the right posterior triangle of the neck. +he physician decided to incise the abscess and insert the drain. ' days later she ca#e for the follow0up and reported that her neck was no longer painful but she could no longer raise her right hand above her head to brush her hair. a) Which #uscle is re?uired for the patient to raise her right hand above her head to brush! b) Which nerve #ust have been severed during the procedure! c) What other #uscle 4s) of the neck is supplied by this nerve! ANGIOLOGY 2 SEQ to be e!e"te# Q1) a) *a#e the palpable arteries on the face and where their pulsations can be felt. b) <riefly describe their course 4s) and enu#erate their branch 4s). Q%) a) Which vessel is utili@ed clinically to #easure the pressure in the right atriu#! b) 8escribe its for#ation c) =nu#erate its various tributaries Q.) & patient diagnosed with a #alignant lacri#al gland tu#or was shown to final year ,.<.<.). students. +hey palpated all the head and neck ly#ph nodes. 3ut of the# which ly#ph nodes would you e2pect to enlarge in this case!

%ISCERA &'# GLANDS 2 SEQ to be e!e"te# Q1) & patient of .' years of age presented in eye 3 8 with a co#plaint of co#plete ptosis of right eye. 8octor e2a#ined his affected eye by raising the lid #anually. 1e found that the position of eyeball is downward and outwards, dilated pupil non0reactive to light and no acco##odation refle2. a) *a#e the nerve involved b) -ustify the above #entioned signs and sy#pto#s Q%) & fe#ale patient ca#e with co#plaints of pain and discharge fro# the left ear. 3n e2a#ination ty#panic #e#brane was red and bulging on the affected side. )he was diagnosed as a case of otitis #edia 4infla##ation of ty#panic cavity). a) Which blood vessels are e2pected to engorge to show redness of ty#panic #e#brane! b) "ive the boundary walls of ty#panic cavity that #ight be involved in the infla##ation.

Q.) & patient of 7( years of age presented with a #alignant tu#or of parotid gland in front of the right ear. )urgical e2cision of the gland was advised as a part of the treat#ent. a) Which, superficial #ost, structure needs special care during operation! b) =nu#erate the #uscles that #ight get paraly@ed post0surgically. Q6) & patient ca#e to the eye 3 8 with history of trau#a to the left eye and co#plained of flashes of light in front of the affected eye field. &fter perfor#ing slit0la#p e2a#ination the ophthal#ologist observed clots of blood in the vitreous hu#or. 1e diagnosed it as a case of retinal detach#ent. a) Which retinal layers are liable to be detached! b) Which retinal blood vessels would lacerate to bleed into the vitreous hu#or! Q') & bo2er encountered a blow to his nose after which he was having great difficulty in breathing and had heavy epista2is. 3n e2a#ination his nasal bridge was seen to be depressed. a) $sing your anato#ical knowledge give the co#position of the structure da#aged. b) *a#e the area, which is responsible for severe bleeding and the blood vessels da#aged in this case.