327.A 13-month-old baby boy is brought into your pediatric office by his
concerned mother. The boy is just beginning to talk and seems to have dif-
ficulty speaking some sounds. The mother had also noted that his tongue
seems “sort of stuck in his mouth” compared to her two older children.
When you examine the baby and look in his mouth, you agree with the
mom that his tongue seems to be stuck in the floor of his mouth. You cor-
rectly explain which of the following to the mother?
a. The hypoglossal nerves that control the tongue must have never developed
b. That the problem could likely be corrected by cutting the lingual frenulum
c. That the problem could likely be corrected by shortening the posterior belly of
the digastric muscle
d. That the problem could likely be corrected by cutting the pterygomandibular
raphe
e. That the problem could likely not be corrected and the speech therapy is the
best option
328.A 19-year-old man comes into your office in extreme pain holding a
handkerchief over his right eye. He explains to you that he was accidentally
struck in the eye with a pool cue and the he can’t see anything other than a
milky white cloud in that eye. You carefully exam his right eye and note
that while there appears to be a scratch on the cornea, the anterior cham-
ber of the eye has partially filled with blood, but the eye has not ruptured.
You use a tonometer and determine that the intraocular pressure is normal.
You tell the patient that it is important to avoid any other blows to the head
since the retina is at increased risk for detachment and to return to the
office the next day to redetermine if the intraocular pressure has risen. You
explain to the patient that the anterior chamber of the eye, where his blood
is, is normally filled with a clear fluid called aqueous humor, which is pro-
duced at the ciliary process. The abnormal red blood cells in the aqueous
humor may plug the normal site of drainage, leading to excessive intraoc-
ular pressure if left untreated. Where in the anterior chamber of the eye
does aqueous humor normally drain?
a. Trabecular meshwork that leads to the scleral venous sinus (canal of Schlemm)
b. Ciliary muscle which has zonular fibers (suspensory ligament of the lens)
attached to it
c. Ciliary process
d. Lens
434 Anatomy, Histology, and Cell Biology