# Which cranial nerve is tested by hoarseness and muscle response after saying “Ah”?

 # Which cranial nerve is tested by hoarseness and muscle response after saying “Ah”? 

a. Glossopharyngeal. 

b. Trigeminal. 

c. Vagus. 

d. Hypoglossal.

The correct answer is C. Vagus.

Testing the glossopharyngeal nerve includes placing a sweet or salty substance on the posterior one third of tongue. To test the trigeminal nerve, the patient is asked to bite down and to touch his/her face. Muscles responses after saying “Ah” hoarseness are test for the vagus nerve. Tongue protrusion is used to test the hypoglossal nerve.

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Primary function of the optic nerve

 # The primary function of the optic nerve is which of the following? 

a. Lateral rectus muscle and eyeball. 

b. Superior oblique muscle and eyeball. 

c. Eyelid and some eyeball. 

d. Vision.

The correct answer is D. Vision.

The abducens nerve acts on the lateral rectus muscle and eyeball. The trochlear nerve acts on the superior oblique muscle and eyeball. The oculomotor nerve acts on the eyelid and some eyeball. The primary function of the optic nerve is vision.

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Which of the following cranial nerves functions in mastication and sensory for the face and mouth?

 # Which of the following cranial nerves functions in mastication and sensory for the face and mouth? 

a. Trigeminal. 

b. Facial. 

c. Glossopharyngeal. 

d. Hypoglossal.

The correct answer is A. Trigeminal.

The trigeminal nerve functions in mastication and sensory for the face and mouth. The facial nerve functions in muscles of facial expression, controlling secretion of tears and saliva, and taste (anterior two thirds of the tongue).

The glossopharyngeal nerve functions in taste (posterior one third of tongue), salivary  secretion, carotid blood pressure, sensory posterior one third of tongue, and stylopharyngeus muscle. The hypoglossal nerve provides motor function to tongue muscles (except palatoglossal).

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Septal hematoma is treated with:

# Septal hematoma is treated with:

A. Incision/Drainage

B. Antibiotics

C. Nasal packing

D. Decongestants

 

The correct answer is A. Incision/Drainage.

Treatment of septal hematoma is performed via small incisions through the mucoperichondrium to evacuate the blood. After the drainage the nose is packed or quilting stitches are put in. Silicone stents can also be used to prevent re-accumulation of the hematoma. 

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Cells accumulated during allergic reactions

 # Which type of cell accumulates wherever allergic reactions take place (e.g., asthma)? 

a. Neutrophils. 

b. Monocytes. 

c. Eosinophils. 

d. Basophils.

The correct answer is C. Eosinophils.

Neutrophils can squeeze through the capillary walls and into infected tissue where they  kill invaders (e.g., bacteria) and engulf the remnants by phagocytosis. Monocytes leave the blood and become macrophages. Eosinophils are a type of white blood cell that contain granules and take up the  red dye eosin. They accumulate wherever allergic reactions (e.g., asthma) occur. Their natural role is in the defense of parasites and other microorganisms. Basophils are a type of white blood cell filled with blue-staining granules of chemicals including histamine, serotonin, bradykinin, heparin, and cytokines such as prostaglandins and leukotrienes. In addition, basophils can digest microorganisms and are responsible for allergy symptoms.

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Hemidesmosomes connect which of the following structures:

 # Hemidesmosomes connect which of the following structures? 

a. Connective tissue and basement membrane. 

b. Basement membrane and basal cell layer. 

c. Connective tissue and basal cell layer. 

d. Basal cells.

The correct answer is B. Connective tissue and basal cell layer. 

Anchoring fibrils connect the connective tissue to the basement membrane. Hemidesmosomes connect the basement membrane to the basal cell layer. The connective tissue and basal cell layer do not connect. Hemidesmosomes connect the basement membrane to the basal cell layer.

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Upto what levels of systolic and diastolic blood pressures ambulatory oral surgical care can be safely given?

# Upto what levels of systolic and diastolic blood pressures ambulatory oral surgical care can be safely given?

A. Systolic 120 and diastolic 80 mm of Hg

B. Systolic 140 and diastolic 90 mm of Hg

C. Systolic 160 and diastolic 100 mm of Hg

D. Systolic 200 and diastolic 110 mm of Hg

The correct answer is D. Systolic 200 and diastolic 110 mm of Hg.

Mild or moderate hypertension  (i.e., systolic pressure <200 mm Hg or diastolic pressure <110 mm Hg) is usually not a problem in the performance of  ambulatory oral surgical care, as long as the patient is not having  signs or symptoms of end-organ involvement secondary to the elevated blood pressure. Care of the poorly controlled hypertensive patient includes use of an anxiety-reduction protocol and monitoring of vital signs. 

Epinephrine-containing local anesthetics should be used cautiously; after surgery, patients should be advised to seek medical care for their hypertension. Elective oral surgery for patients with severe hypertension (i.e., systolic pressure of ≥200 mm Hg or diastolic pressure of ≥110 mm Hg) should be postponed until the pressure is better controlled. Emergency oral surgery in severely hypertensive patients should be performed in a well-controlled environment or in the hospital so that the patient can be carefully monitored during surgery and acute blood pressure control can be subsequently arranged.

Ref: Contemporary Oral and Maxillofacial Surgery, 7th Edition, Hupp, Tucker, Ellis, Page 13

End organ damage in case of hypertensive patients could be any one of the following. Signs and symptoms for each of these should be evaluated prior to surgical care. 

 

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