Head and neck: cavernous sinus thrombosis: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Head and neck: cavernous sinus thrombosis

Sample item

A 19-year-old squeezes a pustule on the upper lip near the nose. Three days later he has fever, severe headache, proptosis, chemosis and a painful ophthalmoplegia. Which route allows the infection to reach the cavernous sinus?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Facial, angular and valveless superior ophthalmic veins

The facial vein communicates at the medial canthus through the angular vein with the superior ophthalmic vein, which drains into the cavernous sinus. These veins have no valves, so blood and infection can flow backwards. The area of the upper lip and nose is therefore called the danger area of the face.

Option by option

  • A. Anterior jugular vein to the subclavian vein

    The anterior jugular vein drains the front of the neck and has no intracranial link.

  • B. Facial vein to the internal jugular vein

    The facial vein normally drains to the internal jugular vein, away from the intracranial sinuses.

  • C. Facial, angular and valveless superior ophthalmic veins (correct)

    Correct. The valveless angular and ophthalmic veins carry infection to the sinus.

  • D. Retromandibular vein to the external jugular vein

    The retromandibular and external jugular veins drain the face and scalp extracranially.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Facial, angular and valveless superior ophthalmic veins. The facial vein communicates at the medial canthus through the angular vein with the superior ophthalmic vein, which drains into the cavernous sinus.

Why is "Anterior jugular vein to the subclavian vein" not the answer?

The anterior jugular vein drains the front of the neck and has no intracranial link.

Why is "Facial vein to the internal jugular vein" not the answer?

The facial vein normally drains to the internal jugular vein, away from the intracranial sinuses.

Why is "Retromandibular vein to the external jugular vein" not the answer?

The retromandibular and external jugular veins drain the face and scalp extracranially.

What concept does this question test?

It tests Head and neck: cavernous sinus thrombosis in Anatomy. These veins have no valves, so blood and infection can flow backwards. The area of the upper lip and nose is therefore called the danger area of the face.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck: cavernous sinus thrombosis?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.