1. Chapter 145 Management of Temporal Bone Trauma
Quinton Gopen, M.D.
UCLA Medical Center

2. Question 1: Temporal Bone fractures are classified as longitudinal or transverse based on the fracture line relationship to:
Coronal Plane
Axial Plane
Sagital Plane
Petrous Ridge
Temporal Line

3. Question 2 Temporal bone fractures entering into the otic capsule generally result from blows to the
Temporal Region
Occipital Region
Parietal Region
Frontal Region
Parasaggital Region

4. Question 3 The incidence of otic capsule involvement is generally considered to occur in what percentage of temporal bone fractures? 5%
10%
20%
40%
80%

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Question 4 Pediatric temporal bone fractures differ from adult temporal bone fractures in that pediatric fractures have a lower incidence of
Facial nerve involvement
Intracranial complications
Comminuted fractures
Concurrent C-spine injuries
None of the above

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Question 5 An 18y.o. man sustains a temporal bone fracture based on initial head CT on presentation to the ER. The patient complains of pain over the fracture site and hearing loss. The patient has no vertigo, nystagmus or other neurologic symptoms. What is the next best test to obtain?
MRI scan brain
CT angiography
Caloric testing
VEMP testing
CT temporal bones

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Question 6 A 74 y.o. man sustains a temporal bone fracture. The fracture extends through the geniculate ganglion and is comminuted. The man has near complete facial paralysis but does have some minimal movement of the face on maximal effort. His hearing is grossly intact. The best treatment plan is:
Oral corticosteroid therapy
Facial nerve decompression via a transmastoid approach
Facial nerve decompression via a middle fossa approach
Facial nerve decompression via a combined transmasoid-middle fossa approach
Facial nerve decompression via a translabyrinthine approach

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Question 7 The site of facial nerve injury in the majority of temporal bone fractures is the:
Vertical segment
Horizontal segment
Perigeniculate region
Meatal segment
Second genu of the facial nerve

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Question 8 The theoretical time for the maximal regeneration of axoplasmic flow is considered to be how long after the injury
Immediately following the injury
1 day
3 days
10 days
21 days

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Question 9 An ENoG results showing this percentage of degeneration or greater of the facial nerve is generally considered to be an indication for surgical exploration and decompression (Fisch criteria)
50%
75%
90%
95%
100%

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Question 10 The best initial treatment for acute posttraumatic CSF otorrhea is:
Bed rest
Serial lumbar punctures
Lumbar drain
Surgical exploration with closure of the ear canal
Surgical exploration with mastoid obliteration

12. Chapter 129 Physiology of the Auditory System
Quinton Gopen, M.D.
UCLA Medical Center

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Question 1 What is the resonant frequency of the external auditory canal?
5300 Hz
3000 HZ
1200 Hz
800 Hz
100 Hz

14. Question 2 What is labeled as “
Question 2 What is labeled as “?” in the adjacent histopathologic slide? ?
Helicotrema
Scala Tympani
Scala Media
Scala Vestibuli
Organ of Corti

15. Question 3 A patient presents with a mixed hearing loss
Question 3 A patient presents with a mixed hearing loss. The vestibular evoked myogenic potential response is recorded at a sound threshold of 120dB? What is the most likely diagnosis
Otosclerosis
Superior semicircular canal dehisence
Meniere’s Disease
Connexin 26 gene mutation
Usher’s syndrome

16. Question 4 Type I spiral ganglion cells:
Less common than type II spiral ganglion cells
Are myelinated
Project to between 3 and 5 inner hair cells
Project to between 3 and 5 outer hair cells
None of the above

17. Question 5 The auditory cortex is located within the
Temporal lobe
Occipital lobe
Parietal lobe
Brainstem
Midbrain

18. Question 6 The speed of sound waves in air is roughly
120 meters per second
340 meters per second
630 meters per second
1220 meters per second
1500 meters per second

19. Question 7 The cochlear duct is filled with
Endolymphatic fluid
Perilymphatic fluid
Dense collagen like material
Cerebrospinal fluid
Loose fibrous tissue

20. Question 8 What is considered the first relay station for all ascending auditory information
Lateral lemniscus
Auditory nerve
Medial geniculate body
Cochlear nucleus
Heschyl gyrus

21. Question 9 Binaural squelch refers to
The ability of the brainstem auditory nuclei to increase the signal to noise ratio
Signal received by both ears is greater in amplitude than the signal received by a single ear
Outer hair cell control over the inner hair cells
Uncomfortable feedback created by hearing aids
The sound in your mind created by reading this question

22. Question 10 The primary auditory cortex is tonotopically tuned such that the highest frequencies are at the
medial aspect
lateral aspect
superior aspect
inferior aspect
Central aspect