Ear Questions PDF Past Paper

**Question 1:** A 5-year-old child presents with recurrent otitis media leading to the insertion of grommets (ventilation tubes) in the tympanic membrane. Which part of the tympanic membrane is the most appropriate site for grommet insertion to avoid damaging important structures? A) Pars flaccida...

**Question 1:** A 5-year-old child presents with recurrent otitis media leading to the insertion of grommets (ventilation tubes) in the tympanic membrane. Which part of the tympanic membrane is the most appropriate site for grommet insertion to avoid damaging important structures? A) Pars flaccida in the superior quadrant B) Pars tensa in the anterior-inferior quadrant C) Umbo at the center of the tympanic membrane D) Pars tensa in the posterior-superior quadrant **Answer:** B) Pars tensa in the anterior-inferior quadrant --- **Question 2:** During a surgical procedure involving the middle ear, a surgeon aims to avoid damaging the nerve that innervates the stapedius muscle. Which cranial nerve provides innervation to this muscle? A) Trigeminal nerve (V) B) Facial nerve (VII) C) Glossopharyngeal nerve (IX) D) Vagus nerve (X) **Answer:** B) Facial nerve (VII) --- **Question 3:** A patient presents with loss of taste sensation from the anterior two-thirds of the tongue and hyperacusis (sensitivity to loud sounds). A lesion is suspected in which part of the facial nerve as it passes through the temporal bone? A) Before the geniculate ganglion B) At the stylomastoid foramen C) At the level of the chorda tympani D) Within the facial canal proximal to the nerve to stapedius **Answer:** D) Within the facial canal proximal to the nerve to stapedius --- **Question 4:** An elderly patient reports progressive hearing loss, particularly difficulty hearing high-frequency sounds. This is most likely due to degeneration of hair cells located in which part of the cochlea? A) Apex of the cochlea B) Base of the cochlea C) Middle turn of the cochlea D) Helicotrema **Answer:** B) Base of the cochlea --- **Question 5:** A patient with a middle ear infection develops pain and vesicular eruptions in the external auditory meatus. Which nerve is most likely involved, causing these symptoms? A) Auriculotemporal nerve (branch of V3) B) Greater auricular nerve (C2-C3) C) Auricular branch of the vagus nerve (X) D) Lesser occipital nerve (C2) **Answer:** C) Auricular branch of the vagus nerve (X) --- **Question 6:** A child presents with mastoiditis following an untreated otitis media. Infection has spread to the mastoid air cells. Through which wall of the middle ear did the infection most likely pass? A) Tegmental wall (roof) B) Jugular wall (floor) C) Mastoid wall (posterior wall) D) Labyrinthine wall (medial wall) **Answer:** C) Mastoid wall (posterior wall) --- **Question 7:** In a case of severe head trauma, a patient exhibits cerebrospinal fluid (CSF) otorrhea (leakage from the ear). Which structure is most likely damaged to allow CSF to leak into the middle ear? A) Tegmen tympani of the temporal bone B) Tympanic membrane C) Oval window membrane D) Round window membrane **Answer:** A) Tegmen tympani of the temporal bone --- **Question 8:** A patient experiences vertigo and nystagmus when turning their head quickly. Dysfunction in which part of the inner ear is most likely responsible for these symptoms? A) Cochlea B) Utricle and saccule C) Semicircular canals D) Eustachian tube **Answer:** C) Semicircular canals --- **Question 9:** Damage to the labyrinthine artery can lead to sudden loss of hearing and balance. This artery is typically a branch of which vessel? A) External carotid artery B) Basilar artery C) Anterior inferior cerebellar artery (AICA) D) Middle cerebral artery **Answer:** C) Anterior inferior cerebellar artery (AICA) --- **Question 10:** A patient with chronic otitis media develops a cholesteatoma (abnormal skin growth) that erodes the ossicles. Loss of which ossicle would most significantly impair the transmission of sound vibrations from the tympanic membrane to the oval window? A) Malleus B) Incus C) Stapes D) Lenticular process **Answer:** C) Stapes --- **Question 11:** An otoscopic examination reveals a perforation in the posterior-superior quadrant of the tympanic membrane. Which structure is at greatest risk of injury due to this perforation? A) Chorda tympani nerve B) Tensor tympani muscle C) Promontory of the cochlea D) Stapedius muscle tendon **Answer:** A) Chorda tympani nerve --- **Question 12:** A patient presents with loss of sensation over the anterior part of the external ear and external auditory canal. Which nerve is most likely affected? A) Great auricular nerve (C2-C3) B) Auriculotemporal nerve (branch of V3) C) Lesser occipital nerve (C2) D) Facial nerve (VII) **Answer:** B) Auriculotemporal nerve (branch of V3) --- **Question 13:** A surgeon performing a mastoidectomy must be cautious not to damage the sigmoid sinus. Which wall of the middle ear is closest to the sigmoid sinus? A) Tegmental wall (roof) B) Jugular wall (floor) C) Mastoid wall (posterior wall) D) Carotid wall (anterior wall) **Answer:** C) Mastoid wall (posterior wall) --- **Question 14:** A newborn fails a hearing screening test. Imaging reveals agenesis (absence) of the organ of Corti. Which membrane within the cochlea is directly associated with the organ of Corti? A) Reissner's membrane (vestibular membrane) B) Basilar membrane C) Tectorial membrane D) Tympanic membrane **Answer:** B) Basilar membrane --- **Question 15:** An infection spreads from the nasopharynx to the middle ear via the Eustachian tube. Which muscle, involved in opening the Eustachian tube during swallowing, is innervated by the mandibular division of the trigeminal nerve? A) Tensor veli palatini B) Levator veli palatini C) Salpingopharyngeus D) Tensor tympani **Answer:** A) Tensor veli palatini --- **Question 16:** A patient exhibits hyperacusis due to paralysis of a muscle in the middle ear. Which muscle is paralyzed, and which nerve is likely damaged? A) Tensor tympani muscle; mandibular nerve (V3) B) Stapedius muscle; facial nerve (VII) C) Tensor tympani muscle; facial nerve (VII) D) Stapedius muscle; glossopharyngeal nerve (IX) **Answer:** B) Stapedius muscle; facial nerve (VII) --- **Question 17:** Following a temporal bone fracture, a patient loses vestibular function but retains hearing. Which part of the inner ear is most likely damaged? A) Bony labyrinth involving the cochlea B) Membranous labyrinth involving the cochlear duct C) Semicircular canals of the membranous labyrinth D) Ossicles of the middle ear **Answer:** C) Semicircular canals of the membranous labyrinth --- **Question 18:** A patient presents with vertigo and hearing loss due to excess endolymphatic fluid pressure (Ménière's disease). Which structure is responsible for the absorption of endolymph and may be malfunctioning? A) Endolymphatic sac B) Perilymphatic duct C) Cochlear aqueduct D) Vestibular aqueduct **Answer:** A) Endolymphatic sac --- **Question 19:** During surgical repair of the tympanic membrane, care must be taken to avoid the long process of the incus. Which quadrant of the tympanic membrane should be avoided to prevent damage to the incus? A) Anterior-inferior quadrant B) Posterior-inferior quadrant C) Anterior-superior quadrant D) Posterior-superior quadrant **Answer:** D) Posterior-superior quadrant --- **Question 20:** A patient has a tumor compressing the internal acoustic meatus. Which two cranial nerves are most likely affected? A) Facial nerve (VII) and Vestibulocochlear nerve (VIII) B) Glossopharyngeal nerve (IX) and Vagus nerve (X) C) Trigeminal nerve (V) and Abducens nerve (VI) D) Hypoglossal nerve (XII) and Accessory nerve (XI) **Answer:** A) Facial nerve (VII) and Vestibulocochlear nerve (VIII) --- **Question 21:** A child with otitis media develops difficulty swallowing and loss of the gag reflex. The infection has likely spread to involve which cranial nerve? A) Facial nerve (VII) B) Glossopharyngeal nerve (IX) C) Vagus nerve (X) D) Hypoglossal nerve (XII) **Answer:** B) Glossopharyngeal nerve (IX) --- **Question 22:** A patient presents with conductive hearing loss due to fixation (ankylosis) of the stapes footplate at the oval window. This condition is known as: A) Otosclerosis B) Otitis externa C) Ménière's disease D) Presbycusis **Answer:** A) Otosclerosis --- **Question 23:** During a complicated extraction of an impacted molar, a dentist inadvertently damages a nerve that results in hyperacusis. Which nerve was likely damaged during the procedure? A) Chorda tympani nerve B) Inferior alveolar nerve C) Nerve to stapedius (branch of VII) D) Nerve to tensor tympani (branch of V3) **Answer:** D) Nerve to tensor tympani (branch of V3) --- **Question 24:** An acoustic neuroma (vestibular schwannoma) arises from Schwann cells of which component of the vestibulocochlear nerve? A) Cochlear nerve B) Superior vestibular nerve C) Inferior vestibular nerve D) Both cochlear and vestibular nerves **Answer:** D) Both cochlear and vestibular nerves --- **Question 25:** A patient complains of dizziness when moving their head, but hearing is unaffected. Imaging reveals a blockage in the arterial supply to the vestibular apparatus. Which artery is most likely occluded? A) Common cochlear artery B) Anterior vestibular artery C) Spiral modiolar artery D) Stylomastoid artery **Answer:** B) Anterior vestibular artery --- **Question 26:** A child with congenital syphilis presents with sensorineural hearing loss. The infection has most likely damaged which structure in the inner ear? A) Hair cells of the organ of Corti B) Ossicles of the middle ear C) Tympanic membrane D) Eustachian tube **Answer:** A) Hair cells of the organ of Corti --- **Question 27:** A patient suffers from an acoustic reflex loss, where loud sounds no longer trigger a protective muscle contraction in the middle ear. Which two muscles are involved in this reflex? A) Tensor tympani and stapedius muscles B) Tensor veli palatini and levator veli palatini muscles C) Salpingopharyngeus and stylopharyngeus muscles D) Cricothyroid and posterior cricoarytenoid muscles **Answer:** A) Tensor tympani and stapedius muscles --- **Question 28:** A patient develops Bell's palsy affecting the facial nerve proximal to the chorda tympani branching. Which of the following symptoms would NOT be expected? A) Loss of taste sensation from the anterior two-thirds of the tongue B) Hyperacusis due to stapedius paralysis C) Dry eye due to lacrimal gland dysfunction D) Loss of sensation in the external auditory canal **Answer:** D) Loss of sensation in the external auditory canal --- **Question 29:** An elderly patient presents with difficulty in balance and reports that objects appear to move when he turns his head (oscillopsia). Damage to which structure is most likely responsible? A) Macula of the utricle B) Crista ampullaris of the semicircular canals C) Organ of Corti D) Otolithic membrane of the saccule **Answer:** B) Crista ampullaris of the semicircular canals --- **Question 30:** In testing the vestibulo-ocular reflex, a physician moves a patient's head rapidly to one side and observes the eye movements. This reflex depends on the functioning of which structure? A) Cochlea B) Semicircular canals C) Eustachian tube D) Tympanic membrane **Answer:** B) Semicircular canals --- **Question 31:** A patient with a history of chronic ear infections develops Gradenigo's syndrome, characterized by otorrhea, pain in the distribution of the trigeminal nerve, and lateral rectus palsy. The infection has spread to which location? A) Mastoid air cells B) Petrous apex of the temporal bone C) Middle cranial fossa D) Internal acoustic meatus **Answer:** B) Petrous apex of the temporal bone --- **Question 32:** A tumor compressing the glossopharyngeal nerve as it exits the skull would affect which ganglion involved in parotid gland secretion? A) Geniculate ganglion B) Otic ganglion C) Pterygopalatine ganglion D) Submandibular ganglion **Answer:** B) Otic ganglion --- **Question 33:** A patient exhibits loss of corneal reflex due to a lesion affecting cranial nerve VII. Which nucleus within the brainstem provides the efferent fibers for this reflex? A) Spinal nucleus of V B) Facial motor nucleus C) Edinger-Westphal nucleus D) Superior salivatory nucleus **Answer:** B) Facial motor nucleus --- **Question 34:** An individual experiences decreased salivation from the submandibular gland. Damage to which nerve passing through the middle ear is most likely responsible? A) Greater petrosal nerve B) Lesser petrosal nerve C) Chorda tympani nerve D) Tympanic nerve **Answer:** C) Chorda tympani nerve --- **Question 35:** A patient with an inner ear infection develops nystagmus beating toward the right when cold water is introduced into the left ear canal (Caloric test). This indicates: A) Normal vestibular function B) Left vestibular dysfunction C) Right vestibular dysfunction D) Bilateral vestibular dysfunction **Answer:** A) Normal vestibular function --- **Question 36:** A fracture of the base of the skull injures the carotid canal. Which wall of the middle ear is immediately adjacent to this canal and may be damaged? A) Tegmental wall (roof) B) Jugular wall (floor) C) Anterior wall (carotid wall) D) Posterior wall (mastoid wall) **Answer:** C) Anterior wall (carotid wall) --- **Question 37:** An infection of the external acoustic meatus results in coughing due to stimulation of which nerve supplying sensory fibers to this area? A) Glossopharyngeal nerve (IX) B) Vagus nerve (X) C) Facial nerve (VII) D) Mandibular nerve (V3) **Answer:** B) Vagus nerve (X) --- **Question 38:** A patient presents with conductive hearing loss due to fluid accumulation in the middle ear (effusion). Which structure is primarily responsible for equalizing pressure and allowing drainage from the middle ear? A) Eustachian tube (pharyngotympanic tube) B) Round window C) Oval window D) Mastoid air cells **Answer:** A) Eustachian tube (pharyngotympanic tube) --- **Question 39:** A genetic mutation affects the development of otoconia (calcium carbonate crystals). Which part of the vestibular system will be directly impacted? A) Crista ampullaris of the semicircular canals B) Maculae of the utricle and saccule C) Cupula of the ampullae D) Organ of Corti **Answer:** B) Maculae of the utricle and saccule --- **Question 40:** During a neurological examination, a patient cannot perceive sounds conducted through bone but can hear sounds conducted through air. This indicates a defect in which part of the ear? A) External ear structures B) Middle ear ossicles C) Inner ear hair cells D) Eustachian tube **Answer:** C) Inner ear hair cells ---