USMLE Question #527: Real Exam Question with Answer & Explanation

A 24-year-old man is brought to the emergency department 40 minutes after he was involved in a motor vehicle collision. He was the unrestrained driver. He is conscious. Physical examination shows numerous lacerations and ecchymoses over the face. His vision is normal. Ocular, facial, and lingual movements are intact. The gag reflex is present. Sensation to pinprick is absent over the right side of the face anterior to the right ear, extending down along the full extent of the mandible to the chin. Sensation also is absent over the right side of the tongue. X-rays of the skull show fractures of the orbit, zygomatic arch, and infratemporal fossa. The most likely cause of these findings is a fracture affecting which of the following locations?