Individual Readiness Assurance Test (iRAT) 4 Head and Neck Practice Test

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• After robotic surgery to repair the lateral collateral ligament, a 38-year-old plumber has severe arm pain with atrophy; most likely diagnosis?
• Which condition is among the differential diagnoses for neurological symptoms described in a young patient with numbness and visual disturbances?
• Which nerve provides taste sensation to the posterior tongue?
• The nasopalatine nerve is a branch of which division of the trigeminal nerve?
• In CRPS type I, which scenario is commonly observed regarding injury association?
• The superior thyroid artery most commonly arises from which vessel?
• The hard palate is primarily innervated by which maxillary nerve branch?
• The internal carotid artery is a direct continuation of which artery?
• The nasociliary nerve is a branch of which division of the trigeminal nerve?
• The thyroid cartilage forms the anterior wall of which structure?
• For patients with whiplash-associated disorder, determining if low risk factors are present for ROM assessment helps decide whether radiographic evaluation is needed.
• Which muscle is innervated by C1 fibers traveling with the hypoglossal nerve to elevate the hyoid?
• Which of the following is a common differential diagnosis to consider when evaluating suspected thoracic outlet syndrome?
• Which nerves contribute to the gag reflex?
• Through which foramen does the ophthalmic division (V1) of CN V exit the skull?
• Which nerve supplies the posterior belly of the digastric muscle?
• Which gland is traversed by the facial nerve within its substance?
• Andrew Phillips, a 22 year old presenting with arm numbness and hand tingling, asks which procedures the medical community would use to reach the same diagnosis. According to the Merck Manual, diagnosis of TOS usually includes which of the following?
• Frontal sinus drains into which region of the nasal cavity?
• Which nerve provides general sensation to the anterior two-thirds of the tongue?
• The left recurrent laryngeal nerve loops around which structure?
• In a case where a patient experiences a motor vehicle accident trauma with head forced backward and severe upper cervical pain, which fracture is most likely?
• Which arteries contribute to the posterior circulation by joining to form the basilar artery?
• According to Souza, cervical facet injections were NOT associated with greater reduction in pain after 3 months in whiplash-associated disorder patients.
• Which nerve provides parasympathetic innervation to the parotid gland?
• Which nerve provides motor innervation to the cricothyroid muscle?
• Where does the common carotid artery bifurcate into internal and external carotids?
• Which nerve provides motor innervation to the intrinsic muscles of the tongue?
• Common carotid bifurcation occurs around which cervical level?
• The taste sensation from the posterior one-third of the tongue is carried by which nerve?
• Which nerve provides taste to the posterior one-third of the tongue?
• Which of the following is NOT a possible cervical injury in this context?
• Emily Garcia, a 40-year-old electrician, has neck stiffness and arm numbness/tingling that follows the medial arm after a motor vehicle accident. According to Souza, what percentage of TOS physical therapists acquire TOS due to trauma?
• In conservative management of thoracic outlet syndrome, which of the following is NOT recommended?
• Which muscle forms the floor of the mouth?
• Tonsillar lymph nodes drain most directly to which deep cervical node?
• The cricoid cartilage is unique because it is which of the following?
• A 32-year-old patient with neck stiffness and arm pain who reports cold fingers that worsen with keyboard use would most likely be examined with which maneuver?
• Which cranial nerve innervates the muscles of facial expression?
• Where is the thyroid gland located relative to the trachea, and which tracheal rings does its isthmus cross?
• Which symptom or presentation is NOT observed in Complex Regional Pain Syndrome Type 1?
• According to Souza, which of the following is NOT considered conservative management for TOS?
• All of the following would be used to diagnose TOS according to Merck Manual EXCEPT which?
• Which ganglion is involved in parasympathetic innervation of the parotid gland via glossopharyngeal nerve?
• Which nerve provides motor innervation to all intrinsic laryngeal muscles except the cricothyroid?
• In conservative management of thoracic outlet syndrome, strengthening the pectoral muscles is included.
• Which nerves exit the skull through the jugular foramen?
• Parasympathetic fibers to the parotid gland travel with which nerve?
• In patients with positionally related arm numbness and secondary neck complaints, which approach is recommended?
• Which statement accurately describes CRPS type II?
• Which of the following is not a known site of thoracic outlet compression?
• Which nerve supplies the motor to the anterior belly of the digastric?
• Which neurologic exam finding would be least helpful in differentiating thoracic outlet syndrome from other neck-arm conditions?
• Which statement about CRPS type I is incorrect?
• Postganglionic parasympathetic fibers to the parotid gland hitchhike with which nerve?
• Which of the following is a common initial management step for suspected thoracic outlet syndrome?
• Foramen through which the maxillary division (V2) exits the skull is?
• Parasympathetic innervation to the parotid gland travels via which pathway?
• In a case where the patient develops severe arm pain and atrophy two days after surgery with negative sensorimotor evaluation, what is the MOST LIKELY diagnosis?
• What forms the roof of the oropharynx?
• Which fascia forms the anterior boundary of the retropharyngeal space?
• Neurogenic thoracic outlet syndrome involves compression of which structure?
• The auriculotemporal nerve is a branch of which division of the trigeminal nerve?
• Which of the following statements about the diagnostic workup for TOS is most accurate according to standard clinical practice?
• Which case describes CRPS after a radial head fracture?
• Which imaging finding is NOT pathognomonic for TOS and is often encountered incidentally?
• The laryngeal inlet is bounded laterally by which structures?
• Which nerve, a branch of the mandibular division of the trigeminal nerve, supplies sensation to the cheek?
• Which receptors in the carotid sinus respond to arterial pressure changes?
• Which nerve provides motor innervation to the tensor veli palatini?
• Which percentage is cited for cervical radiculopathy recovery in the source material?
• The Level I lymph node groups in the neck include which regions?
• Numbness due to overuse or direct trauma with weakness and hypesthesia on the skin may indicate compression of ___.
• Which nerve provides motor innervation to the cricothyroid muscle?
• Which condition is NOT typically differentiated from thoracic outlet syndrome by neurological examination?
• Which symptom would most strongly suggest thoracic outlet syndrome over cervical myelopathy?
• The afferent limb of the carotid sinus reflex is primarily carried by which nerve?
• Which cranial nerves pass through the jugular foramen?
• The lingual nerve is a branch of which division of the trigeminal nerve?
• Compared with other neuropathic pain syndromes, CRPS shows greater involvement of which system?
• The anterior belly of the digastric is innervated by which division of the trigeminal nerve?
• Which history of present illness (HPI) question SHOULD be asked if thoracic outlet syndrome (TOS) is suspected?
• Which structure anchors the tongue to the floor of the mouth?
• Which muscles are innervated by the accessory nerve (CN XI)?
• Which gland is traversed by the facial nerve within its substance?
• The afferent limb of the gag reflex is mediated by which nerve?
• Which structure is NOT contained within the carotid sheath?
• Which case involves a 38-year-old plumber with arm pain after robotic surgery to repair a torn ligament?
• The retropharyngeal space lies between which fascia layers?
• Chorda tympani carries taste from the anterior two-thirds and is a branch of which cranial nerve?
• The thyroid glands receive arterial supply from which arteries?
• Stensen's duct opens opposite which maxillary tooth?
• Damage to which nerve would abolish sensation above the vocal cords?
• The phrenic nerve arises from which spinal nerve roots?
• The foramen through which the facial nerve exits the skull to supply the face is?
• The taste sensation from the anterior two-thirds of the tongue travels via which nerve?
• Which management approach is NOT considered a conservative measure for TOS according to Souza?
• The sensory nerve above the vocal cords is a branch of which nerve?
• In a patient presenting with face and arm numbness, blurry and double vision, and clumsiness, which two differential diagnoses are MOST LIKELY?
• Name the three major salivary glands.
• What is the primary arterial supply to the face?
• The pharyngeal constrictor muscles are primarily innervated by which nerve?
• What percentage of cervical radiculopathy patients fully recover or have only mild residual dysfunction?
• Which bone forms the floor of the anterior cranial fossa and contains the cribriform plate?
• When conservatively managing a patient with thoracic outlet syndrome (TOS), the Doctor of Chiropractic should include the following EXCEPT:
• All of the following are differential diagnoses for thoracic outlet syndrome except which?
• Numbness may be subjective, may be bilateral, and may involve the central nervous system.
• Facial vein drains into which major vein?
• Which cervical lymph node level is located along the upper deep jugular chain?
• The sensation of the external auditory canal is primarily via which nerve?
• The motor innervation to the intrinsic muscles of the tongue is via which nerve?
• A 26-year-old cellist presents with severe arm pain after robotic surgery to repair torn biceps tendon; the most likely diagnosis is?
• Which symptom is commonly observed in CRPS type I but is not exclusive to the condition?
• Which statement about Waldeyer's ring is true?
• Stensen's duct is associated with which salivary gland?
• The nerve that supplies sensation to the cheek is a branch of which division of the trigeminal nerve?
• Which nerve supplies all intrinsic laryngeal muscles except the cricothyroid?
• Thoracic outlet syndrome presents with ______ arm symptoms like numbness and tingling.
• The skin over the angle of the mandible and the parotid region is supplied by which nerve?
• The general sensation of the anterior two-thirds of the tongue is via which nerve?
• Which division of the trigeminal nerve exits the skull through the superior orbital fissure?
• The carotid sheath contains which three structures?
• In thoracic outlet syndrome, arm symptoms most commonly follow which pathway?
• Which statement about CRPS pathophysiology is true?
• The cranial nerves IX, X, and XI pass through which skull opening?
• The external carotid artery gives rise to which two arteries commonly cited in head and neck anatomy?
• The efferent limb of the gag reflex is mediated by which nerve?
• The left venous angle is formed by the junction of which veins?
• Which cranial nerves pass through the superior orbital fissure?
• The great auricular nerve arises from which spinal nerve roots?
• Which pathophysiologic mechanism is characteristic of CRPS and helps maintain inflammation?
• Which description best characterizes the sensory distribution typically seen in thoracic outlet syndrome?
• Which scenario is most consistent with complex regional pain syndrome?
• Which of the following sensorimotor findings is typically observed in a Complex Regional Pain Syndrome scenario described in the material?
• CRPS type II is distinguished from type I by which feature?
• Which nerve does NOT pass through the jugular foramen?
• When thoracic outlet syndrome is suspected, which ROS question should be asked?
• Which nerve loops around the aorta before ascending in the tracheoesophageal groove on the left side?
• Which imaging modality is least useful for diagnosing thoracic outlet syndrome?
• Which muscle is innervated by the external branch of the superior laryngeal nerve?
• Which activity commonly worsens symptoms in thoracic outlet syndrome?
• In a patient with neck and arm symptoms suggestive of thoracic outlet syndrome, which test would you most likely perform?
• Which condition is commonly associated with neck and arm pain and may be evaluated with cervical radiography to aid diagnosis?
• The posterior boundary of the hard palate is formed by which bone?
• Which nerve carries preganglionic parasympathetic fibers to the otic ganglion?
• In CRPS cases described, which symptom supports the diagnosis?
• Often TOS patients describe arm symptoms that follow a path down the medial arm to the fourth and fifth fingers.
• The thoracic duct drains into which venous junction?
• The jugular foramen transmits which nerves?
• Name two arteries commonly cited as branches of the external carotid artery.
• Which statement best describes the role of clinical evaluation in diagnosing thoracic outlet syndrome?
• The mandibular division of the trigeminal nerve travels through which opening in the skull?
• In the context of numbness, which statement reflects Souza’s perspective on subjective numbness?
• Which nerve provides sensation above the vocal cords in the larynx?
• Which nerve provides motor innervation to the cricothyroid muscle?
• Which examination maneuver is most commonly used to provoke symptoms in suspected cervical radiculopathy?
• Which anatomical site is a recognized site of compression in thoracic outlet syndrome?
• Which bones form the hard palate?
• Souza notes that a cervical rib seen on a cervical spine series is NOT pathognomonic for thoracic outlet syndrome. Which finding is being described as NOT pathognomonic?
• Which nerve is the primary sensory nerve for the face (divisions V2 and V3 carry most sensation)?
• According to Souza, a cervical rib revealed on a cervical spine series is not pathognomonic for TOS. Which of the following best matches this statement?
• Waldeyer's ring includes which primary tonsils at the oropharyngeal level?
• In a motor vehicle accident scenario, it is important to acquire details such as age, mechanism of injury, and symptoms; all of these are important.
• Which arteries supply the thyroid gland?
• A 22-year-old with arm numbness and tingling that worsens when reaching overhead and with neck pain during those activities should be evaluated for which condition?
• Edna Beal, a 56-year-old diagnosed with cervical radiculopathy, presents with Murphy's sign (painful, palpable liver). Based on these findings, which specialist should she be referred to?
• Cervical facet injections after 3 months in WAD patients did not provide greater pain relief.
• According to Souza, thoracic outlet syndrome presents with which type of arm symptoms such as numbness or tingling?
• Which nerve provides general sensation to the anterior two-thirds of the tongue?
• A cervical rib seen on a cervical spine study is pathognomonic for thoracic outlet syndrome.
• According to Souza, numbness caused by which site presents bilaterally and may involve the central cord?
• Inferior thyroid artery arises from which trunk?
• During thyroidectomy, which nerve is at risk due to its course in the tracheoesophageal groove?
• In a motor vehicle accident, it is important to acquire details such as:
• After taking vitals, palpation, and cervical ROM, which physical examination would you MOST LIKELY perform to assess thoracic outlet syndrome?
• Which case involved a 26-year-old cellist presenting CRPS after robotic surgery to repair torn biceps tendon?
• Which history feature is commonly elicited in patients with suspected thoracic outlet syndrome?
• The posterior one-third of the tongue receives taste via which nerve?
• The maxillary sinus drains into which nasal meatus?
• Which foramen transmits the mandibular division of the trigeminal nerve (V3)?
• Name the three major salivary glands.
• Taste sensation from the epiglottis is carried by which nerve?
• The Eustachian (pharyngotympanic) tube connects the middle ear to which region?
• Which nerve provides taste sensation from the epiglottis?
• The auriculotemporal nerve, which carries postganglionic parasympathetic fibers to the parotid gland, is a branch of which division of the trigeminal nerve?
• Postganglionic parasympathetic fibers to the parotid join which nerve after leaving the otic ganglion?
• Which condition would be included in the differential diagnosis for neck and arm pain and would require evaluation of nerve roots or brachial plexus?
• The posterior one-third of the tongue is primarily innervated for sensation by which nerve?
• Which nerve carries taste from the anterior two-thirds of the tongue?
• According to the Merck Manual, the diagnosis of thoracic outlet syndrome usually includes all of the following EXCEPT?
• Which duct carries frontal sinus drainage toward the middle meatus?
• Which bone forms the posterior boundary of the hard palate?
• The tensor veli palatini muscle is innervated by which nerve?
• Which statement best describes the arm symptoms described in Souza's discussion of TOS?
• Which nerve provides the most sensory information from the face?
• The external branch of the superior laryngeal nerve supplies which muscle?
• Which nerve provides taste sensation to the posterior tongue?
• Diagnostic workup for thoracic outlet syndrome usually includes which of the following?
• Which nerve supplies the posterior belly of the digastric muscle?
• The jugulodigastric node is a deep cervical node at Level which?
• A 22-year-old art student with arm numbness/tingling that worsens with overhead reaching; based on symptoms, the patient should be evaluated for?
• Which nerve carries taste from the posterior tongue?
• In a motor vehicle accident with hyperflexion and hyperextension, all cervical structures can be damaged except:
• Which occupation was represented by the patient in the Emily Garcia case?
• The posterior cricoarytenoid muscle, which abducts the vocal cords, is innervated by which nerve?
• Which nerve provides parasympathetic innervation to the submandibular and sublingual glands?
• Which nerve provides parasympathetic innervation to the submandibular and sublingual glands via the submandibular ganglion?
• The nerve that supplies motor to all muscles of facial expression is which?
• Which of the following is not a neurovascular bundle compression associated with thoracic outlet syndrome?
• Which nerve provides sensation to the skin of the cheek?
• To locate the sensory component affected in numbness or tingling, which option is NOT recommended?
• The foramen through which the mandibular division of the trigeminal nerve exits the skull is?
• Which artery forms part of the posterior circulation by joining to create the basilar artery?
• The structure that anchors the tongue to the floor of the mouth is the
• Which nerve mediates the afferent limb of the gag reflex and provides sensation to the posterior third of the tongue?
• Which nerve is at risk during neck dissections due to its course in the carotid sheath and its motor to the sternocleidomastoid and trapezius?
• Which statement best describes the purpose of a neurological examination in neck and arm pain assessment?
• Which gland has parasympathetic innervation that travels via the otic ganglion?
• In conservative management of thoracic outlet syndrome, which intervention is NOT typically included?
• The internal branch of which nerve provides sensation above the vocal cords?
• Which nerve is the principal motor nerve for the muscles of facial expression?
• Which nerve carries taste from the anterior two-thirds of the tongue?
• According to Souza, numbness due to overuse or direct trauma with weakness and hypesthesia on the skin may indicate compression of which structure?
• The right recurrent laryngeal nerve loops around which structure?
• According to Souza, which of the following is NOT considered conservative management for TOS?
• The external branch of which nerve innervates the cricothyroid muscle?
• The anterior ethmoidal nerve is a branch of which nerve?
• Where are the palatine tonsils located?
• Which nerve provides motor innervation to the intrinsic muscles of the tongue?
• Waldeyer's ring includes which lymphoid tissues?
• A 36-year-old softball coach presents with severe left arm pain after a radial head fracture; the arm is weak with atrophy; no fever. Most likely diagnosis?
• Which structure is most likely involved when numbness and weakness with sensory loss are present due to nerve compression?
• Which nerve provides taste from the anterior two-thirds of the tongue?
• Which nerve provides motor innervation to the soft palate and pharynx (excluding tensor veli palatini)?
• Through which canal does the internal carotid artery enter the skull?
• Parathyroid glands are typically located posterior to which gland?
• Which canal transmits the optic nerve and ophthalmic artery?
• Which history question should be asked if thoracic outlet syndrome is suspected?