Embryology: branchial cleft cyst: 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 · Embryology: branchial cleft cyst

Sample item

A 22-year-old man has a painless cystic swelling at the anterior border of the upper third of sternocleidomastoid that enlarges after an upper respiratory infection. Aspiration yields fluid with cholesterol crystals. What is the embryological cause?

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

The answer and the reasoning

B. Persistence of the cervical sinus from the second pharyngeal cleft

The second arch overgrows the third and fourth clefts to form the cervical sinus, which normally obliterates. If remnants persist, a second branchial cleft cyst forms along the anterior border of sternocleidomastoid. Aspirate contains cholesterol crystals.

Option by option

  • A. Persistence of the first pharyngeal pouch

    The first pouch forms the tubotympanic recess and not a lateral neck cyst.

  • B. Persistence of the cervical sinus from the second pharyngeal cleft (correct)

    Correct. A persistent cervical sinus gives the lateral neck cyst of second-cleft origin.

  • C. Persistence of the third pharyngeal pouch

    The third pouch forms thymus and inferior parathyroid, not a cervical cyst.

  • D. Persistence of the thyroglossal duct

    A thyroglossal duct cyst is midline and moves with swallowing.

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.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Persistence of the cervical sinus from the second pharyngeal cleft. The second arch overgrows the third and fourth clefts to form the cervical sinus, which normally obliterates.

Why is "Persistence of the first pharyngeal pouch" not the answer?

The first pouch forms the tubotympanic recess and not a lateral neck cyst.

Why is "Persistence of the third pharyngeal pouch" not the answer?

The third pouch forms thymus and inferior parathyroid, not a cervical cyst.

Why is "Persistence of the thyroglossal duct" not the answer?

A thyroglossal duct cyst is midline and moves with swallowing.

What concept does this question test?

It tests Embryology: branchial cleft cyst in Anatomy. If remnants persist, a second branchial cleft cyst forms along the anterior border of sternocleidomastoid. Aspirate contains cholesterol crystals.

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 Embryology: branchial cleft cyst?

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.