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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 Tongue: hypoglossal nerve palsy?

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.

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Tongue: hypoglossal nerve palsy MCQ (B7-ANAT6-27)

Q: What is the answer to this Anatomy question?

The best answer is A, The right hypoglossal nerve is injured, and the unopposed left genioglossus pushes the tongue toward the right. Genioglossus protrudes the tongue by pulling the root forward and pushes the tongue to the opposite side when it acts alone.

Q: What concept does this question test?

It tests Tongue: hypoglossal nerve palsy in Anatomy. When one hypoglossal nerve is cut, the healthy genioglossus is unopposed and the tongue deviates toward the paralysed side, which also shows wasting. The hypoglossal nerve runs close to the carotid bifurcation and can be injured during endarterectomy.

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Anatomy · Tongue: hypoglossal nerve palsy

Sample item

After carotid endarterectomy a 66-year-old man's tongue deviates to the right when protruded and the right half is wasted. Which statement is correct?

AThe right hypoglossal nerve is injured, and the unopposed left genioglossus pushes the tongue toward the rightBThe right vagus nerve is injured, since it supplies the intrinsic muscles of the tongueCThe left hypoglossal nerve is injured, and the unopposed right genioglossus pushes the tongue toward the rightDThe right hypoglossal nerve is injured, and the right genioglossus contracts alone and pushes the tongue toward the right

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

The answer and the reasoning

A. The right hypoglossal nerve is injured, and the unopposed left genioglossus pushes the tongue toward the right

Genioglossus protrudes the tongue by pulling the root forward and pushes the tongue to the opposite side when it acts alone. When one hypoglossal nerve is cut, the healthy genioglossus is unopposed and the tongue deviates toward the paralysed side, which also shows wasting. The hypoglossal nerve runs close to the carotid bifurcation and can be injured during endarterectomy.

Option by option

A. The right hypoglossal nerve is injured, and the unopposed left genioglossus pushes the tongue toward the right (correct)
Correct. The tongue deviates toward the side of the lower motor neurone lesion.
B. The right vagus nerve is injured, since it supplies the intrinsic muscles of the tongue
The tongue muscles are supplied by the hypoglossal nerve, not the vagus.
C. The left hypoglossal nerve is injured, and the unopposed right genioglossus pushes the tongue toward the right
A left-sided lesion would make the tongue deviate to the left.
D. The right hypoglossal nerve is injured, and the right genioglossus contracts alone and pushes the tongue toward the right
The paralysed right genioglossus cannot contract, so the explanation is wrong.

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.

Tongue: hypoglossal nerve palsy: practice question

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The answer and the reasoning

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