INBDE FINAL EXAM QUESTIONS
AND CORRECT ANSWERS
2024/2025 LATEST UPDATE
Patient: 40-year-old male
Chief complaint: The patient is in a hospital emergency room. He says, "My upper teeth
on the right side really hurt. I have pain in my face
and a fever. Also, my eye feels really weird."
Background/or patient history: None at this time.
Current Findings: The patient has a temperature of 102 F. The patient's right eyelid is
drooping, and the right eye is drifting medially. A CT scan reveals thrombosis of the
cavernous sinus, as well as an abscess of the third right maxillary molar.
The cavernous sinus has a direct connection to which of the following dural venous
sinuses? (check all that apply)
A. Superior petrosal sinuses
B. Sigmoid sinuses
C. Superior sagittal sinus
D. Transverse sinuses
E. Inferior petrosal sinuses - Answer- A. Superior petrosal sinuses
The superior petrosal sinuses connect between the transverse sinuses and the
cavernous sinuses.
E. Inferior petrosal sinuses
The inferior petrosal sinuses connect between the superior bulbs of the internal jugular
veins and the cavernous sinuses.
Patient: 3-year-old female
Chief complaint: The patient has come for a routine checkup and cleaning.
Background/or patient history: This is the patient's first dental visit.
Current Findings: While the patient was in the waiting room, epistaxis began in the left
side of her nose. Blood continues to drip from the left
nostril after she sits in your dental chair. She is crying, and you notice that the tears
coming from her left eye are bloody.
,"According to the current clinical guidelines by the American Academy of Pediatric
Dentistry, the patient is compliant with the recommended age for a child's first dental
visit."
A. True
B. False - Answer- B. False
Feedback: The first examination is recommended at the time of the eruption of the first
tooth and no later than 12 months of age.
Patient: 3-year-old female
Chief complaint: The patient has come for a routine checkup and cleaning.
Background/or patient history: This is the patient's first dental visit.
Current Findings: While the patient was in the waiting room, epistaxis began in the left
side of her nose. Blood continues to drip from the left
nostril after she sits in your dental chair. She is crying, and you notice that the tears
coming from her left eye are bloody.
Which arteries could be involved in the epistaxis? (Select all correct answers)
A. Superior labial
B. Sphenopalatine
C. Anterior ethmoidal
D. Greater palatine
E. Lesser palatine - Answer- A. Superior labial
The superior labial artery is a branch of the facial artery. Its septal branch runs
superiorly to enter the nostril
B. Sphenopalatine
The sphenopalatine artery is a branch of the maxillary artery. After entering the nasal
cavity via the sphenopalatine foramen, it has an extensive distribution on both septal
and lateral surfaces, and contributes to the arterial plexus of Kiesselbach's area at the
anterior septum.
C. Anterior ethmoidal
The anterior ethmoidal artery is a branch of the ophthalmic artery. After passing through
the anterior ethmoidal foramen of the ethmoid bone, it supplies the anterior and superior
regions of the nasal cavity, on both septal and lateral surfaces, and contributes to the
arterial plexus of Kiesselbach's area at the anterior
septum.
D. Greater palatine
The greater palatine artery is a branch of the maxillary artery. After supplying the hard
palate, its nasal branch passes through the incisive canal to join Kiesselbach's area.
Patient: 3-year-old female
, Chief complaint: The patient has come for a routine checkup and cleaning.
Background/or patient history: This is the patient's first dental visit.
Current Findings: While the patient was in the waiting room, epistaxis began in the left
side of her nose. Blood continues to drip from the left
nostril after she sits in your dental chair. She is crying, and you notice that the tears
coming from her left eye are bloody.
Which of the following is likely involved in the patient's symptoms? (Select all correct
choices)
A. Bleeding in Kiesselbach's area
B. The nasolacrimal duct
C. The incisive canal
D. Maxillary sinusitis
E. Perforation of the cornea - Answer- A. Bleeding in Kiesselbach's area
Kiesselbach's area is a plexus of arterial supply located anteriorly on the nasal septum,
and is the most common source of epistaxis.
B. The nasolacrimal duct
The nasolacrimal duct connects between the inferior meatus of the nasal cavity and the
orbit (specifically the lacrimal sac in the medial corner of the eye). In the presence of
pressure in the nasal cavity (e.g., due to squeezing of the nose during a nosebleed),
blood can pass up through the nasolacrimal canal into the medial
corner of the eye and mix with tears.
Patient: 3-year-old female
Chief complaint: The patient has come for a routine checkup and cleaning.
Background/or patient history: This is the patient's first dental visit.
Current Findings: While the patient was in the waiting room, epistaxis began in the left
side of her nose. Blood continues to drip from the left
nostril after she sits in your dental chair. She is crying, and you notice that the tears
coming from her left eye are bloody.
Which nerve elements are involved? (Select all correct choices)
A. Greater petrosal nerve
B. Pterygopalatine ganglion
C. Ciliary ganglion
D. CN V1 (Ophthalmic)
E. Lesser petrosal nerve - Answer- A. Greater petrosal nerve
Preganglionic parasympathetics that are secretomotor to the lacrimal gland originate
with the superior salivatory nucleus and CN VII. The preganglionic fibers fibers travel
with the greater petrosal nerve to reach the pterygopalatine ganglion, where they
synapse. Postganglionic parasympathetics travel with the zygomatic nerve of CN V2
and then the lacrimal nerve of CN V1 to reach the lacrimal gland.
B. Pterygopalatine ganglion
AND CORRECT ANSWERS
2024/2025 LATEST UPDATE
Patient: 40-year-old male
Chief complaint: The patient is in a hospital emergency room. He says, "My upper teeth
on the right side really hurt. I have pain in my face
and a fever. Also, my eye feels really weird."
Background/or patient history: None at this time.
Current Findings: The patient has a temperature of 102 F. The patient's right eyelid is
drooping, and the right eye is drifting medially. A CT scan reveals thrombosis of the
cavernous sinus, as well as an abscess of the third right maxillary molar.
The cavernous sinus has a direct connection to which of the following dural venous
sinuses? (check all that apply)
A. Superior petrosal sinuses
B. Sigmoid sinuses
C. Superior sagittal sinus
D. Transverse sinuses
E. Inferior petrosal sinuses - Answer- A. Superior petrosal sinuses
The superior petrosal sinuses connect between the transverse sinuses and the
cavernous sinuses.
E. Inferior petrosal sinuses
The inferior petrosal sinuses connect between the superior bulbs of the internal jugular
veins and the cavernous sinuses.
Patient: 3-year-old female
Chief complaint: The patient has come for a routine checkup and cleaning.
Background/or patient history: This is the patient's first dental visit.
Current Findings: While the patient was in the waiting room, epistaxis began in the left
side of her nose. Blood continues to drip from the left
nostril after she sits in your dental chair. She is crying, and you notice that the tears
coming from her left eye are bloody.
,"According to the current clinical guidelines by the American Academy of Pediatric
Dentistry, the patient is compliant with the recommended age for a child's first dental
visit."
A. True
B. False - Answer- B. False
Feedback: The first examination is recommended at the time of the eruption of the first
tooth and no later than 12 months of age.
Patient: 3-year-old female
Chief complaint: The patient has come for a routine checkup and cleaning.
Background/or patient history: This is the patient's first dental visit.
Current Findings: While the patient was in the waiting room, epistaxis began in the left
side of her nose. Blood continues to drip from the left
nostril after she sits in your dental chair. She is crying, and you notice that the tears
coming from her left eye are bloody.
Which arteries could be involved in the epistaxis? (Select all correct answers)
A. Superior labial
B. Sphenopalatine
C. Anterior ethmoidal
D. Greater palatine
E. Lesser palatine - Answer- A. Superior labial
The superior labial artery is a branch of the facial artery. Its septal branch runs
superiorly to enter the nostril
B. Sphenopalatine
The sphenopalatine artery is a branch of the maxillary artery. After entering the nasal
cavity via the sphenopalatine foramen, it has an extensive distribution on both septal
and lateral surfaces, and contributes to the arterial plexus of Kiesselbach's area at the
anterior septum.
C. Anterior ethmoidal
The anterior ethmoidal artery is a branch of the ophthalmic artery. After passing through
the anterior ethmoidal foramen of the ethmoid bone, it supplies the anterior and superior
regions of the nasal cavity, on both septal and lateral surfaces, and contributes to the
arterial plexus of Kiesselbach's area at the anterior
septum.
D. Greater palatine
The greater palatine artery is a branch of the maxillary artery. After supplying the hard
palate, its nasal branch passes through the incisive canal to join Kiesselbach's area.
Patient: 3-year-old female
, Chief complaint: The patient has come for a routine checkup and cleaning.
Background/or patient history: This is the patient's first dental visit.
Current Findings: While the patient was in the waiting room, epistaxis began in the left
side of her nose. Blood continues to drip from the left
nostril after she sits in your dental chair. She is crying, and you notice that the tears
coming from her left eye are bloody.
Which of the following is likely involved in the patient's symptoms? (Select all correct
choices)
A. Bleeding in Kiesselbach's area
B. The nasolacrimal duct
C. The incisive canal
D. Maxillary sinusitis
E. Perforation of the cornea - Answer- A. Bleeding in Kiesselbach's area
Kiesselbach's area is a plexus of arterial supply located anteriorly on the nasal septum,
and is the most common source of epistaxis.
B. The nasolacrimal duct
The nasolacrimal duct connects between the inferior meatus of the nasal cavity and the
orbit (specifically the lacrimal sac in the medial corner of the eye). In the presence of
pressure in the nasal cavity (e.g., due to squeezing of the nose during a nosebleed),
blood can pass up through the nasolacrimal canal into the medial
corner of the eye and mix with tears.
Patient: 3-year-old female
Chief complaint: The patient has come for a routine checkup and cleaning.
Background/or patient history: This is the patient's first dental visit.
Current Findings: While the patient was in the waiting room, epistaxis began in the left
side of her nose. Blood continues to drip from the left
nostril after she sits in your dental chair. She is crying, and you notice that the tears
coming from her left eye are bloody.
Which nerve elements are involved? (Select all correct choices)
A. Greater petrosal nerve
B. Pterygopalatine ganglion
C. Ciliary ganglion
D. CN V1 (Ophthalmic)
E. Lesser petrosal nerve - Answer- A. Greater petrosal nerve
Preganglionic parasympathetics that are secretomotor to the lacrimal gland originate
with the superior salivatory nucleus and CN VII. The preganglionic fibers fibers travel
with the greater petrosal nerve to reach the pterygopalatine ganglion, where they
synapse. Postganglionic parasympathetics travel with the zygomatic nerve of CN V2
and then the lacrimal nerve of CN V1 to reach the lacrimal gland.
B. Pterygopalatine ganglion
