Otolaryngology Basics Practice Questions

Q: A Montgomery tube is used in which ENT procedure?

Silicone tube. **Explanation:** The **Montgomery T-tube** is a specialized silicone stent used primarily in the management of tracheal stenosis and during tracheal reconstructive surgeries. **1. Why Silicone tube is correct:** The Montgomery tube is manufactured from **medical-grade silicone**. Silicone is the material of choice because it is inert, non-irritating to the respiratory mucosa, and has a smooth surface that resists the crusting of secretions. Its primary function is to act as both a tracheal stent (to maintain the airway patency) and a tracheostomy tube. It consists of a long vertical limb (placed in the trachea) and a short horizontal limb (protruding through the tracheostoma). **2. Analysis of Incorrect Options:** * **Double barrel tube:** This term usually refers to a specific type of tracheostomy tube with an inner and outer cannula or specialized double-lumen endobronchial tubes (like the Carlens tube) used in thoracic surgery, not the Montgomery tube. * **Lobster tail tube:** This is a descriptive name for the **Holinger tracheostomy tube**, which has a series of interlocking rings allowing for flexibility. It is used in patients with an altered tracheal axis or compression. * **Airway tube:** While the Montgomery tube maintains an airway, "Airway tube" is a generic functional description rather than the specific material or structural classification requested by the question. **Clinical Pearls for NEET-PG:** * **Indications:** Subglottic stenosis, tracheal reconstruction, and as a palliative stent for tracheomalacia or extrinsic compression. * **Key Feature:** Unlike a standard tracheostomy tube, the Montgomery tube does not require a flange or tapes to stay in place; the vertical limbs hold it securely within the trachea. * **Management:** The external limb is often plugged to allow the patient to breathe through the natural upper airway and phonate.

Q: Airway noise originating in the nose, nasopharynx, and oropharynx is known as?

Stertor. **Explanation:** The correct answer is **Stertor**. This question tests the ability to differentiate between various types of noisy breathing based on the anatomical site of obstruction. **1. Why Stertor is Correct:** Stertor is defined as a heavy, snoring-type sound produced by vibrations in the **upper airway**—specifically the nose, nasopharynx, and oropharynx. It occurs due to obstruction or narrowing above the level of the larynx. Common causes include adenoid hypertrophy, tonsillar enlargement, or a peritonsillar abscess (Quinsy). Because it originates in the pharyngeal spaces, it is often described as "muffled" or "gurgling" (e.g., the "hot potato voice" in Quinsy). **2. Why the other options are incorrect:** * **Stridor:** This is a high-pitched, musical sound resulting from turbulent airflow through a narrowed **larynx or trachea**. Unlike stertor, stridor is associated with the lower part of the upper respiratory tract. It is further classified into: * *Inspiratory:* Supraglottic/Glottic (e.g., Laryngomalacia). * *Expiratory:* Tracheal/Bronchial (e.g., Foreign body). * *Biphasic:* Subglottic (e.g., Subglottic stenosis). * **Both/None:** These are incorrect because the anatomical distinction between pharyngeal (stertor) and laryngeal/tracheal (stridor) sounds is a fundamental principle in ENT diagnosis. **Clinical Pearls for NEET-PG:** * **Laryngomalacia** is the most common cause of congenital inspiratory stridor. * **Stertor** is the hallmark of snoring and Obstructive Sleep Apnea (OSA). * **Wheezing** is a polyphonic sound originating from the lower airways (bronchi/bronchioles), typically heard during expiration in conditions like asthma. * **Key distinction:** Stertor = "Snore-like" (Pharynx); Stridor = "High-pitched/Musical" (Larynx/Trachea).

Q: The image shows which of the following tests being performed? (Recent NEET Pattern 2016-17)

A= Indirect laryngoscopy, B= Spatula test. ***A= Indirect laryngoscopy, B= Spatula test*** - Image A depicts a mirror being used to visualize the larynx through the oral cavity, which is characteristic of **indirect laryngoscopy**. - Image B shows a spatula held below the nostrils, and nasal patency is assessed by comparing the condensation on its two sides. *A= Posterior rhinoscopy, B= Spatula test* - **Posterior rhinoscopy** involves visualizing the nasopharynx via a mirror placed behind the soft palate, which is not what is shown in Image A. - While Image B correctly shows a spatula test, Image A is clearly not a posterior rhinoscopy. *A= Direct laryngoscopy, B= Spatula test* - **Direct laryngoscopy** uses a laryngoscope to directly visualize the larynx without a mirror, often requiring sedation, which differs from the technique in Image A. - Image A shows the use of a mirror for visualization, thus ruling out direct laryngoscopy. *A= Anterior rhinoscopy, B= Spatula test* - **Anterior rhinoscopy** involves examining the anterior nasal cavity using a nasal speculum, which is not depicted in Image A. - Image A shows examination of the oral cavity and pharynx with a mirror, not the anterior nasal cavity.

Q: The given image shows:

Jobson Horne probe. ***Jobson Horne probe*** - The image displays a **Jobson Horne probe**, an instrument commonly used in **ear, nose, and throat (ENT) procedures**. - It features a **curette** at one end for wax removal and a **cotton wool carrier** at the other for medication application or drying. *Ear Vectis and curette* - An **ear vectis** typically has a small, spoon-shaped or hooked end, while a **curette** is usually scoop-shaped, both designed for cerumen removal. - The instrument shown in the image has two distinct ends, one being a wax curette and the other a cotton carrier, which is characteristic of a Jobson Horne probe, not just a vectis and curette. *Periosteal elevator* - A **periosteal elevator** is used in surgery to lift the **periosteum** (the membrane covering bone) from the bone surface. - These instruments are typically broader, flatter, and more robust, designed for scraping and lifting substantial tissue, unlike the slender instrument shown. *Jansen elevator* - The **Jansen elevator** is a specific type of periosteal elevator often used in **neurosurgery or orthopedic procedures**. - Its design is specialized for bone retraction and has a distinct shape, which differs significantly from the instrument depicted.

Q: Which of the following is correct about the mirror in the instrument shown?

Focal length of 25 cm , diameter of 89 mm. ***Focal length of 25 cm, diameter of 89 mm*** - The instrument shown is a **head mirror**, used in ENT examinations. It is a **concave mirror** with a **focal length of approximately 25 cm**. - The mirror has a **diameter of 89 mm**, which is the standard specification for head mirrors used in clinical ENT practice. *Focal length of 89 mm, diameter of 2.5 inches* - A focal length of **89 mm** is much shorter than the standard for a head mirror, which has a focal length of **25 cm** to focus light effectively at the typical working distance during examination. - A diameter of **2.5 inches** (approximately 63.5 mm) is also smaller than the standard head mirror diameter of 89 mm. *Focal length of 25 cm, diameter of 98 mm* - While the **focal length of 25 cm** is correct, the **diameter of 98 mm** is larger than the standard specification. - The standard head mirror has a diameter of **89 mm**, not 98 mm, making this option incorrect due to the wrong diameter measurement. *Focal length of 89 mm, diameter of 2.5 cm* - A **focal length of 89 mm** is incorrect for a head mirror. The correct focal length is **25 cm**. - A diameter of **2.5 cm** is also significantly smaller than the standard head mirror diameter of 89 mm, making this option incorrect on both measurements.

Q: Which of the following is a non-self-retaining handheld retractor?

Davis retractor. ***Davis Retractor*** - The **Davis retractor** is a **handheld retractor** primarily used in procedures like tonsillectomy to retract the tongue and soft palate, and requires continuous manual holding. - It does not have a locking mechanism or self-retaining features, distinguishing it from retractors designed to stay in place once positioned. *Mollison's mastoid retractor* - The **Mollison's mastoid retractor** is a **self-retaining retractor** commonly used in mastoid surgery. - It features ratcheted arms that lock into position, allowing it to hold tissue apart without continuous manual assistance. *Jansen's mastoid retractor* - The **Jansen's mastoid retractor** is another **self-retaining retractor** with a spring-loaded or ratcheted mechanism. - This design allows it to maintain tissue retraction in mastoid and ear surgeries without requiring a surgeon's constant hold. *Lempert's endaural retractor* - The **Lempert's endaural retractor** is a **self-retaining retractor** specifically designed for endaural approaches to the middle ear. - Its design includes sharp prongs and a flexible but stable frame that anchors in tissue, providing continuous retraction.

Question 1

A Montgomery tube is used in which ENT procedure?

Accepted Answer

Silicone tube

Answer

Double barrel tube

Answer

Lobster tail tube

Answer

Airway tube

Question 2

Airway noise originating in the nose, nasopharynx, and oropharynx is known as?

Accepted Answer

Stertor

Answer

Stridor

Answer

Both of the above

Answer

None of the above

Question 3

The image shows which of the following tests being performed? (Recent NEET Pattern 2016-17)

Accepted Answer

A= Indirect laryngoscopy, B= Spatula test

Answer

A= Posterior rhinoscopy, B= Spatula test

Answer

A= Direct laryngoscopy, B= Spatula test

Answer

A= Anterior rhinoscopy, B= Spatula test

Question 4

The given image shows:

Accepted Answer

Jobson Horne probe

Answer

Ear Vectis and curette

Answer

Periosteal elevator

Answer

Jansen elevator

Question 5

Which of the following is correct about the mirror in the instrument shown?

Accepted Answer

Focal length of 25 cm , diameter of 89 mm

Answer

Focal length of 89 mm , diameter of 2.5 inches

Answer

Focal length of 25 cm , diameter of 98 mm

Answer

Focal length of 89 mm , diameter of 2.5 cm

Question 6

Which of the following is a non-self-retaining handheld retractor?

Accepted Answer

Davis retractor

Answer

Mollison's mastoid retractor

Answer

Jansen's mastoid retractor

Answer

Lempert's endaural retractor

Otolaryngology Basics — MCQs

Otolaryngology Basics — MCQs

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