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ENT MCQs: Anatomy of Ear
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Q-1. Skin over pinna is fixed –

a) Firmly on both sides
b) Loosely on medial side
c) Loosely on lateral side
d) Loosely on both sides
Answer: Loosely on medial side
Explanation:
Auricle or Pinna:
The entire pinna, except its lobule, and the outer part of external acoustic canal
are made up of a framework of a single piece of yellow elastic cartilage.
Skin is closely adherent to the peri-chondrium on its lateral surface while it is
loose on medial surface.
Incisura terminalis- Area between the tragus and crux of the helix and devoid of
cartilage
Important points:
An incision made in Incisura terminalis will not cut through the cartilage and used
for end-aural approach in surgery of external auditory canal or the mastoid.
Cartilage from the tragus, peri-chondrium from the tragus or concha, and fat from
the lobule are frequently used for reconstructive surgery of the middle ear.
The conchal cartilage has also been used to correct the depressed nasal bridge.
The composite grafts of the skin and cartilage from the pinna are sometimes used
for repair of defects of nasal ala.
Q-2. In the external auditory meatus, the cartilaginous portion is –

a) Smaller than bony portion
b) Larger than bony portion
c) Both are equal
d) Devoid of ceruminous glands
Answer: Smaller than bony portion
Explanation:
Cartilaginous part of external acoustic or auditory canal:
It forms outer one-third (8 mm) of the canal.
It has two deficiencies-the “fissures of Santorini” through them the parotid or
superficial mastoid infections can appear in the canal, or vice versa.
It contains hairs, ceruminous and pilo-sebaceous glands which secrete wax
Furuncles are seen in this part due to presence of hairs.
Bony part of external acoustic or auditory canal:
It forms inner two third (16 mm).
Antero-inferior part has deficiency- the foramen of Huschke in children up to the
age of four or sometimes in adults, permitting infections to and from the parotid
It is devoid of hairs and ceruminous glands.
Antero-inferior part presents anterior recess which acts as a cesspool for
discharge and debris in cases of external and middle ear infections.
Q-2 (A). Dehiscence of anterior wall of the external auditory canal cause infection
in the parotid glands via
a) Fissure of Santorini
b) Notch rimus
c) Petrous fissure
d) Retro-pharyngeal fissure
Answer: Fissure of Santorini
Explanation: See above explanation
Q-3. What is the color of the normal tympanic membrane?

a) Pearly white
b) Grey
c) Yellow
d) Red
Answer: Pearly white
Explanation:
Normal color of tympanic membrane is pearly white and semi-transparent and
obliquely set at the medial end meatus.
Tympanic membrane consists of three layers-
1. Outer epithelial layer
2. Inner mucosal layer
3. Middle fibrous layer, which encloses the handle of malleus and has three type
of fibres- the radial, circular and the parabolic.
Perforated tympanic membrane heals usually by two layers and not three.
Q-4. Most reliable landmark in otoscopy is

a) Cone of light
b) Umbo
c) Handle of malleus
d) Lateral process of malleus
Answer: Umbo
Explanation:
Tympanic Membrane:
Pars Tensa:
It forms most of tympanic membrane.
The central part of pars tensa is tented inwards at level of the tip of malleus called
the umbo.
A bright cone of light can be seen radiating from the tip of malleus to the
periphery in the antero-inferior quadrant.
Pars Flaccida or Shrapnel’s Membrane:
Situated above the lateral process of malleus between the notch of Rivinus and
the anterior and posterior malleal fold
Anterior malleolar fold is longer than posterior.
May appear slightly pinkish
Important Points:
Umbo-The most important landmark in normal ear
Lateral process of malleus- The most important landmark in diseased ear as it is
least obliterated in diseases.
Q-5. Cone of light is formed by
a) Anterior malleolar fold
b) Handle of malleus
c) Antero inferior quadrant
d) Pars tensa and pars flaccida
Answer: Handle of malleus
Q-6. Pars Flaccida of the tympanic membrane is also called
a) Reissner’s membrane
b) Shrapnel’s membrane
c) Basilar membrane
d) Secondary tympanic membrane
Answer: Shrapnel’s membrane
Q-7. Which of the following is false about tympanic membrane?
a) Cone of light is antero-inferior
b) Shrapnel’s membrane is also known as pars flaccida
c) Healed perforation has three layers
d) Anterior malleolar fold is longer than posterior.
Answer: Healed perforation has three layers
Q-8. Nerve supply of the external auditory meatus is –
a) Auriculo-temporal nerve by
b) Vagus
c) Facial
d) Trigeminal
Answer: a and b
Explanation:
Nerve supply of External auditory canal:
Auricular temporal nerve (V3):
Anterior wall and roof
Auricular branch of Vagus (CN-X), also called Arnold’s nerve and Sensory fibres
of CN-VII:
Posterior wall and floor
Q-9. Sensory supply of external auditory meatus is by
a) Pterygo-mandibular ganglion
b) Geniculate ganglion
c) Facial nerve
d) Auriculo-temporal nerve
Answer: Auriculo-temporal nerve
Q-10. Major part of the skin of pinna is supplied by –
a) Auriculo-temporal nerve
b) Auricular branch of Vagus nerve
c) Posterior auricular nerve
d) Great auricular nerve
Answer: Great auricular nerve
Explanation:
Nerve supply of Pinna:
Greater auricular nerve (C2, 3):
Most of the medial surface of pinna
Posterior part of the lateral surface of pinna
Lesser occipital nerve (C2):
Upper part of medial surface of pinna
Auricular temporal nerve (V3) – branch of trigeminal nerve:
Tragus, crus of helix and adjacent part of helix
Auricular branch of Vagus (CN-X), also called Arnold’s nerve:
Concha and corresponding eminence on medial surface
Facial nerve:
Concha and retro-auricular groove
Q-11. Nerve supply for external ear are all except
a) Greater occipital nerve
b) Greater auricular nerve
c) Auriculo-temporal nerve
d) Lesser occipital nerve
Answer: Greater occipital nerve
Q-12. Arnold’s nerve is a branch of
a) Vagus
b) Glosso-pharyngeal
c) Auditory
d) Facial
Answer: Vagus
Q-13. All of the following nerves supply auricle and external meatus except
a) Trigeminal nerve
b) Glosso-pharyngeal nerve
c) Auditory nerve
d) Vagus nerve
Answer: Auditory nerve
Q-14. Nerve supply of tympanic membrane is
a) Auriculo-temporal
b) Auriculo branch of vagus
c) Lesser occipital
d) Greater occipital
Answer: a and b
Explanation:
Nerve supply of Tympanic membrane:
Auricular temporal nerve (V3):
Anterior half of lateral surface
Auricular branch of Vagus (CN-X), also called Arnold’s nerve:
Posterior half of lateral surface
Tympanic branch of CN-IX (Jacobson’s nerve):
Medial surface
Q-15. Nerve supply of tympanic membrane
a) Auricular temporal nerve
b) Auricular branch of vagus
c) Occipital nerve
d) Great auricular nerve
e) Glosso-pharyngeal nerve
Answer: a, b, and e
Q-16. Facial recess or the posterior sinus is bounded by
a) Medially by the vertical part of VIIth nerve
b) Laterally by the chorda tympani
c) Above by the fossa incudis
d) All of the above
Answer: All of the above
Explanation:
Facial recess or posterior sinus:
It is depression in the posterior wall lateral to the pyramid.
It is bounded medially by vertical part of VIIth nerve, laterally by the chorda
tympani and above by the fossa incudis.
Surgically, facial recess is important, as direct access can be made through this
into the middle ear without disturbing posterior canal wall.
Q-17. Tegmen separates middle ear from the middle cranial fossa containing
temporal lobe of brain by-
a) Medical wall of middle ear
b) Lateral wall of middle ear
c) Roof of middle ear
d) Anterior wall of middle ear
Answer: Roof of middle ear
Explanation:
The roof of the middle ear is formed by a thin plate of bone called Tegmen
tympani.
It separates tympanic cavity from the middle cranial fossa by roof of the aditus
and antrum.
It also extends posteriorly to form the roof of the aditus and antrum.
Q-18. Floor of middle ear cavity is in relation with
a) Internal carotid artery
b) Bulb of internal jugular vein
c) Sigmoid sinus
d) Round window
Answer: Bulb of internal jugular vein
Explanation:
The floor of the middle ear is thin plate of bone which separates tympanic cavity
from jugular bulb.
Sometimes, it is congenitally deficient and jugular bulb may then project into
middle ear, separated from the cavity only by the mucosa.
Q-19. Promontory seen in the middle ear is –
a) Jugular bulge
b) Basal turn of cochlea
c) Semi-circular
d) Head of incus
Answer: Basal turn of cochlea
Explanation:
The Medial Wall of the Middle Ear:
The medial wall is formed by labyrinth.
It presents
A bulb called promontory which is due to the basal coil of cochlea
Round window and
Oval window
Distance of promontory or medial wall of middle ear from tympanic membrane is
about 2 mm.
Above the oval window is the canal for facial nerve.
Just anterior to the oval window, the medial wall presents a hook like projection
called the process of cochleariformis. The tendon of tensor tympani takes a turn
here to get attachment to the neck of malleus.
Q-20. Process cochleoformis attaches to
a) Tendon of tensor tympani
b) Basal turns of helix
c) Handle of malleus
d) Incus
Answer: Tendon of tensor tympani
Q-21. The distance between tympanic membrane and medial wall of middle ear at
level of centre is
a) 3 mm
b) 4 mm
c) 6 mm
d) 2 mm
Answer: 2 mm
Q-22. Distance of promontory from tympanic membrane
a) 2 mm
b) 5 mm
c) 6 mm
d) 7 mm
Answer: 2 mm
Q-23. The landmark on the lateral surface of temporal bone which acts as a guide
to surgery to the antrum is the
a) Trautmann’s triangle
b) Temporal line
c) Supra-meatal Spine of henle
d) Notch of Rivinus
e) None of the above
Answer: Supra-meatal Spine of henle
Explanation:
MacEwen’s or supra-meatal triangle:
The lateral wall of antrum is marked by externally on the surface of mastoid by
MacEwen’s or supra-meatal triangle.
MacEwen’s or supra-meatal triangle is bounded by temporal line, postero-superior
segment of bony external auditory canal and the line drawn as a tangent to
external auditory canal.
Spine of Henle lies in this triangle.
It is an important landmark to locate the mastoid antrum in mastoid surgery.
Q-24. Anatomical landmark indicating position of mastoid antrum –
a) Supra-meatal triangle
b) Spine of Henle
c) Tip of the mastoid process
d) None
Answer: Supra-meatal triangle
Q-25. MacEwen’s triangle is the landmark for
a) Maxillary sinus
b) Mastoid antrum
c) Frontal sinus
d) None
Answer: Mastoid antrum
Q-27. All of the following form the boundary of MacEwen’s triangle except:
a) Temporal line
b) Postero-superior segment of bony external auditory canal
c) Promontory
d) Tangent drawn to the external auditory meatus
Answer: Promontory
Q-28. The supra-meatal triangle overlies the
a) Mastoid antrum
b) Mastoid air cells
c) Antrum
d) Facial nerve
Q-29. Korner’s septum is seen in
a) Petro-squamous suture
b) Temporo-squamous suture
c) Petro-mastoid suture
d) Fronto-zygomatic suture
Answer: Petro-squamous suture
Explanation:
Development of Mastoid/ Korner’s Septum:
Mastoid develops from the squamous and petrous bones.
The petro-squamosal suture may persist as a bony plate called the Korner’s
septum.
It separates superficial squamosal cells from the deep petrosal cells.
Important Points:
Korner’s septum is surgically important as it may cause difficulty in locating the
antrum and the deeper cells.
Thus it may lead to incomplete removal of disease at Mastoidectomy.
Q-30. Stapes foot plate covers
a) Round window
b) Oval window
c) Inferior sinus tympan
d) Pyramid
Answer: Oval window
Explanation:
The oval window, an opening between scala vestibuli and the middle ear, lies at
the end of the cochlea nearest the middle ear, the basal end.
The oval window is covered by the footplate at the stapes in the middle ear.
The round window, a membrane-covered opening between the scala tympani and
the middle ear also lies at the basal end of the cochlea.
Because fluid of the inner ear in non-compressible, inward movement of the
stapes footplate is allowed because of the yielding of the thin membrane which
covers the round window.
This is essential to the transmission process, since it provides elastic relief for the
fluid of the inner ear, thus permitting movement of the stapes and the structures
of the inner ear.
Q-31. What is type of joints between the ossicles of ear?
a) Fibrous joint
b) Primary cartilaginous
c) Secondary cartilaginous joints
d) Synovial joints
Answer: Synovial joints
Explanation:
Ossicles/ Ossicular articulations:
Malleus is the most lateral of ossicles.
Incus is the largest of three ossicles.
Stapes is the smallest of the ossicles.
Incudo-malleolar joint > A saddle type of synovial joint
Incudo-stapedial joint > A ball and socket of synovial joint
Q-32. Stapedius is supplied by –
a) Maxillary nerve
b) Facial nerve
c) Auditory nerve
d) Mandibular nerve
Answer: Facial nerve
Explanation:
Stapedius:
It attaches to the neck of stapes and helps to dampen very loud sounds thus
preventing noise trauma to the inner ear.
Nerve supply- a branch of CN VII
Q-33. Regarding Stapedial reflex, which of the following is true:
a) It helps to enhance the sound conduction in the middle ear
b) It is protective reflex against loud sound
c) It helps in masking the sound waves
d) It is unilateral reflex
Answer: It is protective reflex against loud sound.
Q-34. Tensor tympani is supplied by:
a) Facial nerve
b) Vagus nerve
c) Trigeminal nerve
d) Glosso-pharyngeal nerve
Answer: Trigeminal nerve
Explanation:
Tensor Tympani:
It attaches to the neck of malleus and tenses the tympanic membrane.
Nerve supply- a branch of mandibular nerve (V3) which is one of the divisions of
the trigeminal nerve
Q-35. Sensory nerve supply of middle ear cavity is provided by
a) Facial
b) Glosso-pharyngeal nerve
c) Vagus
d) Trigeminal
Answer: Glosso-pharyngeal nerve
Explanation:
Tympanic plexus lies on the promontory and is formed by tympanic branch of
glosso-pharyngeal, and sympathetic fibres from the plexus round the internal
carotid artery.
It supplies innervation to the medial surface of the tympanic membrane, tympanic
cavity, mastoid air cells and the bony eustachian tube.
It also carries secreto-motor fibres for the parotid gland.
Q-36. Inner ear is present in which bone
a) Parietal bone
b) Petrous part of temporal bone
c) Occipital bone
d) Petrous part of squamous bone
Answer: Petrous part of temporal bone
Explanation:
Internal ear:
The internal ear or labyrinth lies in the petrous part of the temporal bone.
It consists of bony labyrinth within which there is a membranous labyrinth.
The membranous labyrinth is filled with a fluid called endo-lymph. It is separated
from the bony labyrinth by another fluid called the peri-lymph.
Q-37. Inner ear bony labyrinth is-
a) Strongest bone in the body
b) Cancellous bone
c) Cartilaginous bone
d) Membranous bone
Answer: Cartilaginous bone
Explanation:
The bony labyrinth is formed from mesenchyme surrounding the membranous
labyrinth.
The mesenchyme condensation is soon converted into cartilage.
This cartilaginous labyrinth is subsequently ossified to form the bony labyrinth.
Q-38. Most potential route for transmission of meningitis from CNS to Inner ear is-
a) Cochlear aqueduct
b) Endolymphatic sac
c) Vestibular aqueduct
d) Hyrtle fissure
Answer: Cochlear aqueduct
Explanation:
The Bony Cochlea/ Aqueduct of cochlea:
It consists of three parts:
1. Vestibule
2. Semi-circular Canals
3. Cochlea
The bony cochlea contains three compartments: Scala vestibule, Scala tympani
and Scala media
The Scala vestibule and Scala tympani are filled by peri-lymph and communicate
with each at apex of cochlea through an opening called helicotrema.
Scala vestibuli is closed by the footplate of stapes. Movement of stapes causes
vibration in scala vestibuli.
Scala tympani is closed by secondary tympanic membrane and it is also
connected with the subarachnoid space through the aqueduct of cochlea.
CSF or infection from brain passes into scala tympani through aqueduct of
cochlea.
Q-39. Cochlear aqueduct-
a) Connects internal ear with subarachnoid space
b) Connects cochlea with vestibule
c) Contains endo-lymph
d) Same as S. media
Answer: Connects internal ear with subarachnoid space
Q-40. Movement of stapes causes vibration in
a) Scala media
b) Scala tympani
c) Scala vestibuli
d) Semi-circular canal
Answer: Scala vestibuli
Q-41. Site where endo-lymph is seen-
a) Scala vestibule
b) Scala media
c) Helicotrema
d) Organ of corti
Answer: Scala media
Explanation:
Membranous labyrinth consists of the cochlear duct or the Scala media or
membranous cochlea, the utricle, saccule, the three semi-circular ducts, and the
endo-lymphatic duct and sac.
The non-ampullated ends of posterior and superior canals unite to form a
common channel called the crus commune.
The membranous labyrinth is filled by endo-lymph while the space between
membranous labyrinth and bony labyrinth is filled with peri-lymph.
Q-42. Crus commune is in:
a) Cochlea
b) Middle ear
c) Behind retina
d) Part of lens
Answer: Cochlea
Q-43. Organ of corti is situated in
a) Scala media
b) S. Tympani
c) S. Vestibuli
d) Saccule
Answer: Scala media
Explanation:
The Scala Media or Cochlear Duct: Organ of Corti
It is a blind sac.
Its three walls are formed by
The basilar membrane, which supports the organ of corti,
The Reissner’s membrane which separates it from the scala vestibule
The stria vascularis, which contains vascular epithelium and is concerned with
secretion of endo-lymph
Important Points:
The scala media or cochlear duct is connected to the saccule by ductus reuniens.
Higher frequencies of sound are heard at basal coil while lower ones are heard at
the typical coil.
Q-44. Endolymph in the inner ear-
a) Is filtrate of blood serum
b) Is secreted by Stria vascularis
c) Is secreted by Basilar membrane
d) Is secreted by Hair cells
Answer: Is secreted by Stria vascularis
Q-45. Endolymph in inner ear is produced by?
a) Phalangeal cells
b) Stria vascularis
c) Lamina spiralis ossea
d) Cochlear duct
Answer: Stria vascularis
Q-46. Endolymph is secreted by
a) Stria vascularis
b) Basilar membrane
c) Cochlear duct
d) Hensen’s cell
Answer: Stria vascularis
Q-47. Organ of corti is situated in
a) Scala media
b) Utricle
c) Saccule
d) None of the above
Answer: Scala media
Q-48. Organ of corti is arranged along the inner edge of –
a) Reissner’s membrane
b) Basilar membrane
c) Stria Vascular
Answer: Basilar membrane
Q-49. Endolymphatic duct drains into
a) Subdural space
b) External space
c) Subarachnoid space
d) Saccule
Answer: Subdural space
Explanation:
Endolymph fills the entire membranous labyrinth and resembles intracellular fluid,
being rich in K+ ions.
It is secreted by the secretory cells of the stria vascularis o the cochlea and by
dark cells which present in utricle and also near the ampullated ends of semi-
circular ducts.
Longitudinal flow- Endolymph from the cochlea reaches saccule; utricle and
endo-lymphatic duct and get absorbed through endo-lymphatic sac which lies in
the subdural space.
Radial flow- Endolymph is secreted by stria vascularis and also gets absorbed by
the stria vascularis.
Q-50. Endolymphatic duct connects which structure:
a) Scala media to subdural space
b) Scala vestibule to aqueduct of cochlea
c) Scala tympani to aqueduct of cochlea
d) Scala tympani to subdural space
Answer: Scala media to subdural space
Q-51. Labyrinthine artery is a branch of –
a) Internal Carotid artery
b) Basilar artery
c) Posterior cerebellar artery
d) Anterior inferior cerebellar artery
Answer: Anterior inferior cerebellar artery
Explanation:
Blood supply of labyrinth:
Labyrinthine artery which is a branch of antero-inferior cerebellar artery but
sometimes from the basilar
Venous drainage of labyrinth:
Venous drainage is through internal auditory vein, vein of cochlear aqueduct and
vein of vestibular aqueduct which ultimately drain into inferior petrosal sinus and
lateral venous sinus.
Q-52. Peri-lymph contains-
a) Na+
b) K+
c) Mg++
d) Cl –
Answer: Na+
Explanation:
Composition of inner ear fluids:
Constituents of endo-lymph:
Na+ (meq/ L) – 5
K+ (meq/ L) – 144
Protein (mg/ dl) -126
Glucose (mg/ dl) -10-40
Constituents of Peri-lymph:
Na+ (meq/ L) – 140
K+ (meq/ L) – 10
Protein (mg/ dl) -200-400
Glucose (mg/ dl) -85
Q-53. Pinna develops from
a) 1st pharyngeal arch
b) 1st and 3rd pharyngeal arch
c) 1st and 2nd pharyngeal arch
d) 2nd pharyngeal arch
Answer: 1st and 2nd pharyngeal arch
Explanation:
Development of Auricle/ Pinna:
First brachial cleft is the precursor of external auditory canal.
Around the sixth week of embryonic life, a series of six tubercles appear around
the first brachial cleft.
They progressively coalesce to form the auricle.
Tragus develops from the tubercle of the first arch while the rest of pinna
develops from the remaining five tubercles of the second arch.
Q-54. The following structure represents all the 3 components of the embryonic
disc-
a) Tympanic membrane
b) Retina
c) Meninges
Answer: Tympanic membrane
Explanation:
Tympanic membrane develops from the all three germinal layers.
Outer germinal epithelial layer is formed by the ectoderm, inner mucosal layer by
the endoderm and the middle fibrous layer by the mesoderm.
Q-55. Eustachian tube develops from –
a) 2nd and 3rd pharyngeal pouch
b) 1st pharyngeal pouch
c) 2nd pharyngeal pouch
d) 3rd pharyngeal pouch
Answer: 1st pharyngeal pouch
Explanation:
Development of middle year/ The eustachian tube:
The eustachian tube, tympanic cavity, attic, antrum and mastoid air cells develop
from the endoderm of tubo-tympanic recess which arises from the first and partly
from the second pharyngeal pouches.
Malleus and incus are derived from mesoderm of the first arch while the stapes
develop from the second arch except its footplate and annular ligament which are
derived from the otic capsule.
The ossicles begin to form during the 4th week of gestation. At birth, the ossicles
are of nearly adult size.
The mastoid process is not present at birth and starts developing at end of the
first year and reaches its adult size at puberty.
Mastoid antrum is an air filled sinus within petrous part of temporal bone.
Development of the mastoid air cell system doesn’t occur until after birth.
Important point:
The tympanic cavity and maxillary antrum, auditory ossicles and structures of
internal ear are all almost fully developed at birth.
Q-56. All of the following are of the adult size at birth except?
a) Tympanic membrane
b) Ossicles
c) Tympanic cavity
d) Mastoid antrum
Q-57. At birth the following structures are of adult size except:
a) Tympanic cavity
b) Mastoid process
c) Malleus
d) Tympanic ring
Answer: Mastoid process
Q-58. Which of the following attains adult size before birth?
a) Ear ossicles
b) Maxilla
c) Mastoid process
d) Parietal bone
Answer: Ear ossicles

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ENT MCQs: Anatomy of Ear

Q-1. Skin over pinna is fixed –

Q-2. In the external auditory meatus, the cartilaginous portion is –

Q-3. What is the color of the normal tympanic membrane?

Q-4. Most reliable landmark in otoscopy is

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