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Which of the following are called as ‘Signal nodes’?

 # Which of the following are called as ‘Signal nodes’?
A. Supraclavicular nodes
B. Jugulo-omohyoid
C. Jugulodigastric
D. Submandibular



The correct answer is A. Supraclavicular nodes

The left supraclavicular nodes or Virchow's or scalene nodes are also involved in malignant growths of distant organs, e.g. the stomach, the testis and other abdominal organs. Therefore, they are known as signal nodes. Scalene node biopsy is very helpful in the early diagnosis of such malignancies. 

The origin of clavicular head of sternocleidomastoid muscle:

 # The origin of clavicular head of sternocleidomastoid muscle is from the:
A. Medial one third of the inferior surface of the clavicle
B. Lateral one third of the inferior surface of the clavicle
C. Medial one third of the superior surface of the clavicle
D. Lateral one third of the superior surface of the clavicle



The correct answer is C. Medial one third of the superior surface of the clavicle.

Origin of Sternocleidomastoid Muscle

1. The sternal head is tendinous and arises from the superolateral part of the front of the manubrium sterni.
2. The clavicular head is musculotendinous and arises from the medial one third of the superior surface of the clavicle.

Insertion of Sternocleidomastoid Muscle

It is inserted 
a) by a thick tendon into the lateral  surface of the mastoid process from its tip to its superior border, and 
b) by a thin aponeurosis into the lateral half of the superior nuchal line of the occipital bone.


Nerve Supply of Sternocleidomastoid

The spinal accessory nerve provides the motor supply. It passes through the muscle.

Blood supply of the sternocleidomastoid

One branch each from superior thyroid artery and suprascapular artery and two branches from the occipital artery.

Action of  Sternocleidomastoid muscle
# When one muscle contracts:
a) It turns the chin to the opposite side.
b) It can also tilt the head towards the shoulder. 

# When both muscles contract together:
a) They draw the head forwards as in eating and in lifting the head from a pillow. 
b) With the longus colli, they flex the neck against resistance. 
c) The reverse action helps in forced inspiration.




Action of digastric muscle:

 # Following is the action of digastric muscle:
A. Elevates the mandible and depresses the hyoid bone
B. Elevates the hyoid bone and depresses the mandible
C. Depresses the mandible as well as hyoid bone
D. Elevates the mandible as well as hyoid bone



The correct answer is B. Elevates the hyoid bone and depresses the mandible.

Digastric muscle depresses the mandible when the mouth is opened widely or against resistance and elevates the hyoid bone.

Temporalis muscle originates from:

 # Temporalis muscle originates from:
A. Side of the skull
B. Zygomatic process
C. Ramus of the mandible
D. Pterygopalatine fossa



The correct answer is A. Side of the skull.

Temporalis muscle arises from temporal fossa and temporal fascia and inserts into deep surface of coronoid and anterior border of the ramus of mandible. 




Medial pterygoid muscle is attached to:

 # Medial pterygoid muscle is attached to:
A. Medial surface of lateral pterygoid plate
B. Lateral surface of medial pterygoid plate
C. Medial surface of medial pterygoid plate
D. Lateral surface of lateral pterygoid plate



The correct answer is A. Medial surface of the lateral pterygoid plate

Deep head of the medial pterygoid muscle arises from medial surface of lateral pterygoid plate and palatine bone. The lateral pterygoid muscle arises from lateral surface of lateral pterygoid plate.


Lymphatic drainage of TMJ:

 # Lymphatic drainage of TMJ is mainly to:
A. Submandibular nodes
B. Submental nodes
C. Deep cervical nodes
D. Parotid nodes



The correct answer is D. Parotid nodes.

Nerve supply of Capsule of TMJ:

 # Which of the following supplies capsule of TMJ?
A. Facial nerve
B. Auriculotemporal nerve
C. Branch of maxillary nerve
D. First cervical nerve



The correct answer is B. Auriculotemporal nerve.

Sensory nerve supply: Sensory innervation of the TMJ is derived from the auriculotemporal and masseteric branches of V3 (otherwise known as the mandibular branch of the trigeminal nerve).

Blood supply of TMJ: Its arterial blood supply is provided by branches of the external carotid artery, predominantly the superficial temporal branch. Other branches of the external carotid artery, namely, the deep auricular artery, anterior tympanic artery, ascending pharyngeal artery, and maxillary artery, may also contribute to the arterial blood supply of the joint.